THE LIFE BALANCE CLINIC, BEHAVIORAL HEALTH SERVICE (NPI# 1649566894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649566894 |
Entity Type | Organization |
Organization Name | THE LIFE BALANCE CLINIC, BEHAVIORAL HEALTH SERVICE |
Practice Address |
1107 B Openwood St. Vicksburg MS 39183 |
Mailing Address |
113 Woodstone Dr Vicksburg MS 39183-8319 |
Practice Telephone | 6018314402 |
Practice Fax Number | 6012627226 |
Mailing Telephone | 6018314402 |
Mailing Fax Number | 6012627226 |
Enumeration Date | 2011-06-27 |
Last Update Date | 2011-06-27 |
Authorized Official Name | MRS. ANNETTE BRYANT (OWNER) |
Authorized Official Telephone | 6018314402 |
Authorized Official Credential | LCSW-BCD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1041C0700X |
Social Worker Specialization: Clinical |
C6582 | MS | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 08000025 | 05 |
Street Address |
1107 B OPENWOOD ST. |
City | VICKSBURG |
State | MS |
Zip Code | 39183 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
1255777025 | Joyce Wanjugu Muruthi | Obstetrics & Gynecology | 2100 Highway 61 N, Vicksburg, MS 39183 | 2013-05-20 |
1811244858 | Life Balance Clinic LLC | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2012-08-09 |
Find all providers in zip 39183 |
Taxonomy Code | 1041C0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Social Worker |
Specialization | Clinical |
A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174142574 | Billy Foster | Social Worker | 109 Alfred Dr, Vicksburg, MS 39180-9147 | 2020-04-15 |
1841792793 | Impact Behavioral Counseling LLC | Social Worker | 1 Medical Plaza Dr Ste B, Vicksburg, MS 39180-5187 | 2018-03-07 |
1710488804 | Karen Lee | Social Worker | 1205 Monroe St, Vicksburg, MS 39183-2953 | 2018-02-23 |
1063958759 | Karolina Rosol | Social Worker | 15731 S 29th St, Vicksburg, MI 49097-9598 | 2017-01-18 |
1871934497 | Krista K Guynes | Social Worker | 125 Amberleaf Dr, Vicksburg, MS 39180-0895 | 2013-07-11 |
1649427782 | Tempie Bland | Social Worker | 111 Fleetwood Dr, Vicksburg, MS 39180-2578 | 2008-08-20 |
1487860557 | Jessica Sue Parr | Social Worker | 13320 N Blvd, Vicksburg, MI 49097-1514 | 2007-05-15 |
1689774937 | Sharon B Holmberg | Social Worker | 280 Mattingly Rd, Vicksburg, MS 39180-7689 | 2006-09-25 |
1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
1811244858 | Life Balance Clinic LLC | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2012-08-09 |
Find all providers in VICKSBURG |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.