Stand Inbalance, LLC

Primary specialty

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

Legal business name

STAND INBALANCE, LLC

Practice address

5655 Lindero Canyon Rd Ste 726
Westlake Village, CA 91362-4068

Phone

(818) 714-1740

NPI assigned

Jul 25, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Vallerie Coleman, PH.D.NPI 1962629899

Title

Ceo

Phone

(818) 714-1740

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Vallerie Elizabeth Coleman, PH.D.

  • Clinical Psychologist
  • Thousand Oaks, CA
  • NPI 1962629899
  NPD Authorized official
• Hazel Larimer

  • Clinical Social Worker
  • Thousand Oaks, CA
  • NPI 1306101951
  NPD (past)

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1902383565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W CARLISLE RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913615314",
            "telephone_number": "310-367-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 LINDERO CANYON RD STE 726",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624068",
            "telephone_number": "818-714-1740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 W Carlisle Rd",
            "address_purpose": "LOCATION",
            "city": "Thousand Oaks",
            "state": "CA",
            "postal_code": "913615314",
            "country_code": "US",
            "telephone_number": "818-714-1740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STAND INBALANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "VALLERIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-714-1740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY12592",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "1962629899",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.