Basic Information
Provider Information
NPI: 1871022475
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BALINT
FirstName: MARIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9187 SLEEPING TREE ST
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891235350
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 6600 W CHARLESTON BLVD STE 140
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891461067
CountryCode: US
TelephoneNumber: 7024374673
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/07/2017
LastUpdateDate: 06/07/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XMI0831NVY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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