Children in Balance Psychological Associates LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00547 Issued in RI

Legal business name

CHILDREN IN BALANCE PSYCHOLOGICAL ASSOCIATES LLC

Practice address

575 E Main Rd
4
Middletown, RI 02842-5528

Phone

(508) 962-7364

Fax

(401) 619-7766

NPI assigned

Sep 19, 2012

Organization subpart

No

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

Authorized official

Name

Miss Tiffany Bourquin, LMHC

Title

Ceo/Executive Director

Phone

(508) 962-7364

Specialties & licenses 8

Addresses

Other identifiers 2

Other names 1

• Center For Self Care CSC Other name

Locations

Practitioners 1

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

• Tiffany Bourquin Lopes, LMHC

  • Mental Health Counselor
  • Somerset, MA
  • NPI 1669631487
  NPD (past)

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1952651895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 577",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "02726",
            "telephone_number": "508-962-7364",
            "fax_number": "401-619-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E MAIN RD",
            "address_2": "4",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425528",
            "telephone_number": "508-962-7364",
            "fax_number": "401-619-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN IN BALANCE PSYCHOLOGICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "BOURQUIN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "CEO/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "508-962-7364",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "00547",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6722",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "7566",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "7566",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW01724",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "02472",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "RI",
            "license": "MHC00502",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MA",
            "license": "7566",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI 1669631487",
            "identifier": "1669631487",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BH90286",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center For Self Care CSC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ling Cheng
• Melissa Angela Chianese, LCDP
• Child & Family Services of Newport County, Inc.
• Child & Family Services of Newport County, Inc.
• Child and Family Services of Newport County (Child & Family (DBA))
• Judith A Choice, RN
• Christine a. Gill MD
• Samantha Jo Cianci, B.A, M.A
• Robert Cicchelli, MD
• Joshua Ronald Clare, DPT

• Mental Health Counselor in Middletown, RI
• Providers in Middletown, RI by specialty
• Mental Health Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.