NPIMap

Organization Active NPI

Balance Mental Health & Wellness PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Prudenville, MI
National Provider Identifier
1629797857
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BALANCE MENTAL HEALTH & WELLNESS PC
Practice address
3386 W Houghton Lake Dr
Prudenville, MI 48651-9700
Phone
(989) 312-1800
NPI assigned
Aug 23, 2022
Last updated
Sep 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Danielle Fox, LMSWNPI 1790178283
Title
Owner
Phone
(989) 915-2808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3386 W Houghton Lake Dr
Prudenville, MI 48651-9700

Mailing address

PO Box 927
Prudenville, MI 48651-0927
Phone (989) 312-1800

Other identifiers 1

IdentifierTypeStateIssuer
1790178283MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@balancemichigan.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230413001275 MI Part B Supplier - Clinic/Group Practice 2668847278 Receives reassigned benefits from 6 practitioners
Practice locations: Prudenville, MI

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: info@balancemichigan.com

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1629797857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 927",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486510927",
            "telephone_number": "989-312-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3386 W HOUGHTON LAKE DR",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486519700",
            "telephone_number": "989-312-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE MENTAL HEALTH & WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-915-2808",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790178283",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@balancemichigan.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6111 Sequoia Ln",
            "city": "Midland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486427284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prudenville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.