| Name: | Children In Balance Psychological Associates, LLC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 06 Sep 2012 (13 years ago) |
| Identification Number: | 000792969 |
| ZIP code: | 02842 |
| County: | Newport County |
| Principal Address: | 575 EAST MAIN ROAD UNIT 4, MIDDLETOWN, RI, 02842, USA |
| Mailing Address: | PO BOX 577, SOMERSET, MA, 02726, USA |
| Purpose: | CIB IS A BEHAVIORAL HEALTH AND MENTAL HEALTH WELLNESS PRACTICE. WE OFFER INDIVIDUAL, FAMILY, GROUP, AND COUPLES THERAPY FOR YOUTH,FAMILIES,ADULTS AND CHILDREN. OFFERING TELE-THERAPY, PLAY THERAPY, ADULT THERAPY SERVICES, CBT AS WELL AS THERAPEUTIC GROUPS TO ADDRESS A VARIETY OF NEEDS FOR ALL AGE GROUPS. |
NAICS
621420 Outpatient Mental Health and Substance Abuse CentersThis industry comprises establishments with medical staff primarily engaged in providing outpatient services related to the diagnosis and treatment of mental health disorders and alcohol and other substance abuse. These establishments generally treat patients who do not require inpatient treatment. They may provide a counseling staff and information regarding a wide range of mental health and substance abuse issues and/or refer patients to more extensive treatment programs, if necessary. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1952651895 | 2012-09-19 | 2017-04-26 | P.O. BOX 577, SOMERSET, MA, 02726, US | 575 E MAIN RD, 4, MIDDLETOWN, RI, 028425528, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 508-962-7364 |
| Fax | 4016197766 |
Authorized person
| Name | MISS TIFFANY BOURQUIN |
| Role | CEO/EXECUTIVE DIRECTOR |
| Phone | 5089627364 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 00547 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 6722 |
| State | MA |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 7566 |
| State | MA |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 7566 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | CSW01724 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | 02472 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | MHC00502 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 7566 |
| State | MA |
| Is Primary | No |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI 1669631487 |
| Number | 1669631487 |
| Issuer | MEDICAID |
| Number | BH90286 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| TIFFANY BOURQUIN | Agent | 575 EAST MAIN ROAD, MIDDLETOWN, RI, 02842, USA |
| Number | Name | File Date |
|---|---|---|
| 202451081890 | Annual Report | 2024-04-15 |
| 202332347730 | Annual Report | 2023-04-05 |
| 202215398240 | Annual Report | 2022-04-21 |
| 202102423660 | Annual Report | 2021-09-30 |
| 202077308070 | Annual Report | 2020-11-25 |
| 201917200150 | Annual Report | 2019-09-03 |
| 201985107900 | Annual Report | 2019-01-24 |
| 201878733470 | Statement of Change of Registered/Resident Agent Office | 2018-10-02 |
| 201877678880 | Revocation Notice For Failure to Maintain a Registered Office | 2018-09-18 |
| 201877137170 | Registered Office Not Maintained | 2018-08-20 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
