# MINDFULLY BALANCED THERAPY PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457937989
- **Authorized official:** KIMBERLEIGH HAGAR LCSW (OWNER)
- **Authorized official phone:** (847) 447-2919

## Contact information

- **Practice address:** 10020 MONROE RD STE 170-228, MATTHEWS, NC 28105-5485
- **Practice address phone:** (847) 447-2919
- **Mailing address:** 10020 MONROE RD STE 170-228, MATTHEWS, NC 28105-5485
- **Mailing address phone:** (847) 447-2919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | Yes |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/23/2021
- **Last updated:** 04/06/2021