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LIFE BALANCE CLINIC LLC
NPI 1811244858
Social Worker - Clinical in Vicksburg, MS

Active since August 09, 2012
1107 OPENWOOD ST, VICKSBURG, MS 39183(601) 831-4402(601) 206-0672 Get Directions Write a Review

NPPES record last updated: August 7, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Life Balance Clinic Llc NPPES

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

LIFE BALANCE CLINIC LLC (NPI 1811244858) is a healthcare organization registered as a clinical in Vicksburg, Mississippi and active in the NPI registry since August 2012. The organization lists Annette Bryant, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1811244858
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameLIFE BALANCE CLINIC LLC
Location Address1107 OPENWOOD STVicksburg, MS 39183
Mailing Address113 Woodstone DrVicksburg, MS 39183-8319 · (601) 831-4402 · Fax (601) 206-0672
Phone(601) 831-4402
Fax(601) 206-0672
Organization SubpartNo
Authorized OfficialAnnette BryantOwner/provider · (601) 831-4402
Enumeration DateAugust 9, 2012
Last NPPES UpdateAugust 7, 2018
✔ NPI 1811244858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MS · C6582
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.
1107 OPENWOOD ST, Vicksburg, MS 39183
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Life Balance Clinic 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 Life Balance Clinic LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Annette Bryant, LCSW
Clinical Social Worker
NPI 1407878663
1107 OPENWOOD ST
Vicksburg, MS 39183
(601) 831-4402
✔ PECOSSame 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 Life Balance Clinic LLC's NPI number?

The NPI number for Life Balance Clinic LLC is 1811244858. It was assigned to this organization in the NPPES registry on August 9, 2012.

Where is Life Balance Clinic LLC located?

Life Balance Clinic LLC is located at 1107 Openwood St, Vicksburg, MS 39183. The listed phone number is (601) 831-4402.

What is Life Balance Clinic LLC's specialty?

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

Is Life Balance Clinic LLC enrolled in Medicare?

Yes. Life Balance Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Life Balance Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Life Balance Clinic 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 Life Balance Clinic LLC was last updated on August 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.