Provider Demographics
NPI:1154205441
Name:BALOCH, ANEESHA KHAN (MHC-LP)
Entity type:Individual
Prefix:
First Name:ANEESHA
Middle Name:KHAN
Last Name:BALOCH
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PINE WEST PLZ STE 204
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5532
Mailing Address - Country:US
Mailing Address - Phone:518-713-4008
Mailing Address - Fax:518-444-7095
Practice Address - Street 1:2 PINE WEST PLZ STE 204
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5532
Practice Address - Country:US
Practice Address - Phone:518-713-4008
Practice Address - Fax:518-444-7095
Is Sole Proprietor?:No
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP137098101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor