Organization
MINDFULLY BALANCED THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLEIGH HAGAR LCSW (OWNER)
(847) 447-2919
Entity
Organization
Contact information
Practice address
10020 MONROE RD STE 170-228, MATTHEWS, NC 28105-5485
(847) 447-2919
Mailing address
10020 MONROE RD STE 170-228, MATTHEWS, NC 28105-5485
(847) 447-2919
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
03/23/2021
Last updated
04/06/2021
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