Provider Demographics
NPI:1679154900
Name:GUIDING BALANCE - PSYCHIATRIC NP, PLLC
Entity type:Organization
Organization Name:GUIDING BALANCE - PSYCHIATRIC NP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WESTON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC
Authorized Official - Phone:631-680-2124
Mailing Address - Street 1:175 FALCON AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2912
Mailing Address - Country:US
Mailing Address - Phone:631-260-1314
Mailing Address - Fax:
Practice Address - Street 1:122 W ROE BLVD
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2569
Practice Address - Country:US
Practice Address - Phone:631-260-1314
Practice Address - Fax:949-561-4740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty