Organization
BALANCED LIVING THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGGIE C ISHAQ MS, LMHC, SUDP, CCF (OWNER/LICENSED MENTAL HEALTH COUNS)
(425) 977-4988
Entity
Organization
Contact information
Practice address
7500 212TH ST SW STE 205, EDMONDS, WA 98026-7617
(425) 977-4988
Mailing address
7500 212TH ST SW STE 205, EDMONDS, WA 98026-7617
(425) 977-4988
(425) 977-4989
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1253932
KAISER
WA
01
—
1554873
COMMUNITY HEALTH PLAN OF WASHINGTON
WA
01
—
1560659
MOLINA HEALTH CARE OF WASHINGTON
WA
01
—
1950283
PROVIDENCE HEALTH PLAN OF WASHINGTON
WA
05
—
2150671
—
WA
01
—
909035
AETNA
WA
01
—
909040
FIRST CHOICE HEALTH NETWORK
WA
01
—
912650
LIFEWISE OF WA
WA
01
—
916313
CARPENTERS HEALTH AND SECURITY PLAN
WA
Enumeration date
04/13/2013
Last updated
03/30/2024
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