Carmen Ball
Individual provider Active NPI Speech-Language Pathologist · Beckley, WV
NPI 1104097856 · NPPES record last updated Mar 20, 2008
Key facts
- NPI
- 1104097856
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 00658310 (WV)
- Practice address
- 400 Neville St
Beckley, WV 25801-4511 - Phone
- (304) 256-4712
- NPI assigned
- Mar 20, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00658310 | WV | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 00658310 | WV | Yes |
Addresses
Primary practice location
400 Neville St
Beckley, WV 25801-4511
Mailing address
400 Neville St
Beckley, WV 25801-4511
Phone (304) 256-4712
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0152386000 | Medicaid | WV |
Other providers in Beckley, WV
- Elizabeth Baker
- Jennifer R Baker
- Martha A Baker
- Misty M Baker
- Balanced Behavioral Health Services
- Stella Ball
- Taylor Ball
- Eva Cherie Ballard
- Tanya Dawn Ballenger
- Amanda Ballew
All providers in Beckley, WV · Speech-Language Pathologist in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.