Back to Balance Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.016683 Issued in IL

Legal business name

BACK TO BALANCE COUNSELING, LLC

Practice address

5757 S Madison St
Hinsdale, IL 60521-8116

Phone

(773) 936-3196

NPI assigned

Aug 9, 2016

Organization subpart

No

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

Authorized official

Name

Megan Cannon, LCSW

Title

Licensed Clinical Social Worker

Phone

(773) 936-3196

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1811441603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 S MADISON ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605218116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 S MADISON ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605218116",
            "telephone_number": "773-936-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO BALANCE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "773-936-3196",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.