MINDFUL BALANCE THERAPY NPI 1063098051

NPI Information

NPI: 1063098051
Provider Name: MINDFUL BALANCE THERAPY
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
497 N MAIN ST
GLEN ELLYN, IL
ZIP 60137
Phone: (847) 264-0566
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MINDFUL BALANCE THERAPY is a professional counselor in Glen Ellyn, IL. MINDFUL BALANCE THERAPY NPI is 1063098051. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

497 N MAIN ST
GLEN ELLYN, IL
ZIP 60137-171
Phone: (847) 264-0566

The provider's authorized official is Jennifer Lynn Kalani .
The authorized official title is Owner/president and has the following contact phone number (847) 264-0566.

The enumeration date for this NPI number is 3/22/2021 and was last updated on 6/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	180007388	OTHER	ILLINOIS	IDFPR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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