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BALANCED LIFE COUNSELING LLC
NPI 1619634177
Social Worker - Clinical in Wallingford, CT

Active since November 19, 2021
45 FAIR ST, WALLINGFORD, CT 06492(860) 901-7916 Get Directions Write a Review

NPPES record last updated: July 3, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 3, 2023, Jul 20, 2022, Jul 7, 2022 and 1 more (4 updates tracked since 2021).

About Balanced Life Counseling Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BALANCED LIFE COUNSELING LLC (NPI 1619634177) is a healthcare organization registered as a clinical in Wallingford, Connecticut and active in the NPI registry since November 2021. The organization lists Samantha Nicole Forst, Social Worker, as its authorized official.

NPPES Registry Identity

NPI1619634177
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameBALANCED LIFE COUNSELING LLC
Location Address45 FAIR STWallingford, CT 06492-4208
Mailing Address2079 Killingly Cmns # 1019Killingly, CT 06241-2190 · (860) 901-7916
Phone(860) 901-7916
Organization SubpartNo
Authorized OfficialSamantha Nicole ForstSocial Worker · (860) 901-7916
Enumeration DateNovember 19, 2021
Last NPPES UpdateJuly 3, 20234 updates tracked since enumeration
NPPES CertifiedJuly 3, 2023
✔ NPI 1619634177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
45 FAIR ST, Wallingford, CT 06492
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Balanced Life Counseling Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Balanced Life Counseling LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Samantha Forst, LCSW
Clinical Social Worker
NPI 1073193116
45 FAIR ST
Wallingford, CT 06492
(860) 455-8517
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Balanced Life Counseling LLC's NPI number?

The NPI number for Balanced Life Counseling LLC is 1619634177. It was assigned to this organization in the NPPES registry on November 19, 2021.

Where is Balanced Life Counseling LLC located?

Balanced Life Counseling LLC is located at 45 Fair St, Wallingford, CT 06492. The listed phone number is (860) 901-7916.

What is Balanced Life Counseling LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Balanced Life Counseling LLC enrolled in Medicare?

Yes. Balanced Life Counseling LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Balanced Life Counseling LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Balanced Life Counseling LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Balanced Life Counseling LLC was last updated on July 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.