Provider Demographics
NPI:1942987821
Name:CORE BALANCE COUNSELING, LLC
Entity type:Organization
Organization Name:CORE BALANCE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:SPAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-697-1023
Mailing Address - Street 1:2509 S POWER RD STE 110
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-6696
Mailing Address - Country:US
Mailing Address - Phone:480-590-4227
Mailing Address - Fax:
Practice Address - Street 1:2509 S POWER RD STE 110
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-6696
Practice Address - Country:US
Practice Address - Phone:480-590-4227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty