# CHILDREN IN BALANCE PSYCHOLOGICAL ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Center For Self Care CSC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952651895
- **Authorized official:** MISS TIFFANY BOURQUIN LMHC (CEO/EXECUTIVE DIRECTOR)
- **Authorized official phone:** (508) 962-7364

## Contact information

- **Practice address:** 575 E MAIN RD, 4, MIDDLETOWN, RI 02842-5528
- **Practice address phone:** (508) 962-7364
- **Practice address fax:** (401) 619-7766
- **Mailing address:** P.O. BOX 577, SOMERSET, MA 02726
- **Mailing address phone:** (508) 962-7364
- **Mailing address fax:** (401) 619-7766

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 00547 | RI | Yes |
| 101YM0800X | Mental Health Counselor | 6722 | MA | — |
| 101YM0800X | Mental Health Counselor | 7566 | MA | — |
| 101YM0800X | Mental Health Counselor | 7566 | RI | — |
| 1041C0700X | Clinical Social Worker | 02472 | RI | — |
| 1041C0700X | Clinical Social Worker | CSW01724 | RI | — |
| 251S00000X | Community/Behavioral Health Agency | 7566 | MA | — |
| 251S00000X | Community/Behavioral Health Agency | MHC00502 | RI | — |

## Other

- **Enumeration date:** 09/19/2012
- **Last updated:** 04/26/2017