Inner Balance Therapy, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

INNER BALANCE THERAPY, LLC

Practice address

480 S Cache St Ofc 16
Jackson, WY 83001-8222

Phone

(703) 608-1457

NPI assigned

Jul 11, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Kristin Poole, LPCNPI 1982273298

Title

Counselor

Phone

(703) 608-1457

Specialties & licenses 2

Addresses

Practitioners 1

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

• Kristin Poole

  • Professional Counselor
  • Jackson, WY
  • NPI 1982273298
  NPD Authorized official

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1912744301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 BROWN TROUT BND",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "834555072",
            "telephone_number": "703-608-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 S CACHE ST OFC 16",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018222",
            "telephone_number": "703-608-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER BALANCE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "703-608-1457",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Marie Howarth
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• Jackson Family Dentistry

• Adult Mental Health Clinic/Center in Jackson, WY
• Providers in Jackson, WY by specialty
• Adult Mental Health Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.