Organization
BALANCED MIND LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE HIGA LCSW (CLINICIAN)
(818) 642-1349
Entity
Organization
Contact information
Practice address
1125 45TH AVE APT 3B, LONG ISLAND CITY, NY 11101-5176
(818) 642-1349
Mailing address
1125 45TH AVE APT 3B, LONG ISLAND CITY, NY 11101-5176
(818) 642-1349
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/29/2023
Last updated
09/29/2023
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