Equilibrium Brain Body Balance

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EQUILIBRIUM BRAIN BODY BALANCE

Doing business as

Equilibrium

Practice address

12800 Whitewater Dr
Suite 100- 2016
Minnetonka, MN 55343

Phone

(612) 289-3465

NPI assigned

Feb 2, 2023

Last updated

Feb 2, 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

Therese M Houndt-Dalberg, CNP, PMHNPNPI 1861858466

Title

Ceo/Pmhnp

Phone

(612) 289-2365

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Equilibrium Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

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.

• Therese Houndt-Dalberg, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Northfield, MN
  • NPI 1861858466
  Medicare reassignment NPD Authorized official
• Alene Chelman, LICSW

  • Clinical Social Worker
  • Waconia, MN
  • NPI 1154635092
  Medicare reassignment NPD
• Angela M Shengena, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chaska, MN
  • NPI 1215606124
  Medicare reassignment NPD

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1861198723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7730 LAREDO DR UNIT 163",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553171208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 WHITEWATER DR",
            "address_2": "SUITE 100- 2016",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55343",
            "telephone_number": "612-289-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUILIBRIUM BRAIN BODY BALANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "HOUNDT-DALBERG",
        "authorized_official_first_name": "THERESE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO/PMHNP",
        "authorized_official_telephone_number": "612-289-2365",
        "authorized_official_credential": "CNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861858466",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Equilibrium",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gordon Dale Engstrand, D.D.S.
• Melinda Jane Enright, LICSW
• ENT & Sleep Clinics Minnesota LLC
• Nam Yong Eom
• Epiphany Care Homes LLC (Steven's Residence)
• Ruth Anne Erdmann, MSCCC/SLP
• Cara A Ericksen, MSW, LICSW
• Barry G Erickson, APRN
• Keith J Erickson, MD
• Samantha Rose Ernst

• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.