Balanced Mind Wellness Clinic LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BALANCED MIND WELLNESS CLINIC LLC

Practice address

1117 Kirby Rd
Lebanon, OH 45036-9618

Phone

(513) 716-4395

NPI assigned

Nov 26, 2024

Organization subpart

No

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

Authorized official

Name

Allison Damron

Title

Office Manager

Phone

(513) 716-4395

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Meredith A Evans, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cincinnati, OH
  • NPI 1396147435
  Medicare reassignment NPD
• Andrew Paul Leisring, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
  • NPI 1003655309

  OH

  Medicare reassignment NPD

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1689490385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 KIRBY RD",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450369618",
            "telephone_number": "513-716-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 KIRBY RD",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450369618",
            "telephone_number": "513-716-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED MIND WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "DAMRON",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "513-716-4395"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather M Bailey, CDCA
• Joseph Gerard Bailey, M.ED
• Miranda Baise
• Wyatt Grey Baker
• Yvonne L Baker
• Holly Baldwin, PHARMD
• April Ballentine, BS PHARM
• Brandy Kay Balon
• Kelsey L Baltzer, MPT
• Brittany Banks

• Psychiatric/Mental Health Nurse Practitioner in Lebanon, OH
• Providers in Lebanon, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.