Organization Active NPI

Guided Balance Therapy LLC

  • Social Worker
  • Livonia, MI
National Provider Identifier
1780066308
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801060492 Issued in MI
Legal business name
GUIDED BALANCE THERAPY LLC
Practice address
31580 Schoolcraft Rd
Livonia, MI 48150-1805
Phone
(734) 205-9020
Fax
(734) 422-1330
NPI assigned
Jun 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Deborah L Christiansen, LMSWNPI 1093956310
Title
Owner
Phone
(734) 205-9020

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
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 6801060492 MI Primary

Addresses

Primary practice location

31580 Schoolcraft Rd
Livonia, MI 48150-1805

Mailing address

31580 Schoolcraft Rd
Livonia, MI 48150-1805
Phone (734) 205-9020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151120000286 MI Part B Supplier - Clinic/Group Practice 8426358680 Receives reassigned benefits from 1 practitioner
Practice locations: Livonia, MI

National Provider Directory

National Provider Directory

Locations

17318 Farmington Rd
Livonia, MI 48152
Phone (734) 513-0400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780066308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31580 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501805",
            "telephone_number": "734-205-9020",
            "fax_number": "734-422-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31580 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501805",
            "telephone_number": "734-205-9020",
            "fax_number": "734-422-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUIDED BALANCE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSEN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-205-9020",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801060492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.