Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Balance and Renewal PLLC

Organization Clinical Social Worker · NPI 1790645638

Balance and Renewal PLLC provides Clinical Social Worker services in Ammon, Idaho. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2705 E 17th St
Ammon, ID 83406-6669
Phone: (208) 534-6484
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1790645638
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Adam Nickell — Owner/ Provider · (208) 534-6484
NPI enumeratedNovember 13, 2025
Last updated in NPPESNovember 13, 2025
Certification dateNovember 13, 2025
Mailing address3270 E 17th St # 131, Ammon, ID 83406-6758

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