Balance of Mind Therapeutic Support

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BALANCE OF MIND THERAPEUTIC SUPPORT

Practice address

308 4TH Ave NW
Austin, MN 55912-3140

Phone

(507) 438-4026

NPI assigned

Jul 14, 2021

Last updated

Feb 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Daryl James Smith, LICSWNPI 1871018192

Title

Owner

Phone

(507) 438-4026

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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.

• Daryl Smith, LICSW

  • Clinical Social Worker
  • Austin, MN
  • NPI 1871018192
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1841862364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 4TH AVE NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559123140",
            "telephone_number": "507-438-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 4TH AVE NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559123140",
            "telephone_number": "507-438-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE OF MIND THERAPEUTIC SUPPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-438-4026",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871018192",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Matthew Baker Jr., PHARM.D.
• Sebastian Pahl Baker, FNP
• Trina Justine Baker, PA-C
• Manal Bakhiet, MBBS
• Candace Louise Bakker, LPN
• Nicole Ann Barker, CNP
• Donald Paul Bartemes, LICSW
• Kevin Todd Bartenberger, PA-C
• Rebekah Bathon
• Linda Ann Baumann, RDLD

• Community/Behavioral Health Agency in Austin, MN
• Providers in Austin, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.