Balance & Vitality, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BALANCE & VITALITY, PLLC

Practice address

2309 W Cone Blvd Ste 218
Greensboro, NC 27408-4047

Phone

(336) 410-4161

Fax

(336) 436-9141

NPI assigned

Jul 20, 2018

Organization subpart

No

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

Authorized official

Name

Fatima Jordan, MS, LPC, LCASANPI 1821407073

Title

Managing Member

Phone

(336) 410-4161

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Fatima Jordan, LPC, CRC, LCASA

  • Mental Health Counselor
  • Greensboro, NC
  • NPI 1821407073

  Addiction (Substance Use Disorder)

  NPD (past) Authorized official

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1750868071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 W CONE BLVD STE 218",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274084047",
            "telephone_number": "336-410-4161",
            "fax_number": "336-436-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 W CONE BLVD STE 218",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274084047",
            "telephone_number": "336-410-4161",
            "fax_number": "336-436-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE & VITALITY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "FATIMA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "336-410-4161",
        "authorized_official_credential": "MS, LPC, LCASA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1821407073",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith B. Baker, NP
• Sara Anne Baker
• Sarah Baker, MS,CCC-SLP
• Alison L Baklarz, PHARM.D.
• Bindubal Balan, M.D.
• Anna Lane Baldwin, MD
• Madison Leann Baldwin
• Sierra Baldwin
• Sue Ashe Baldwin, ED.D., BCPP,
• Amber Garris Balicki, MA, CCC-SLP

• All providers in Greensboro, NC
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.