Jill A Balk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R023629 Issued in NY

Practice address

15 Edgewood PL
Huntington Station, NY 11746-1306

Phone

(631) 385-9855

Fax

(631) 351-3533

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104970201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EDGEWOOD PL",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461306",
            "telephone_number": "631-385-9855",
            "fax_number": "631-351-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 EDGEWOOD PL",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461306",
            "telephone_number": "631-385-9855",
            "fax_number": "631-351-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALK",
        "first_name": "JILL",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R023629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alexandra Kristin Baker, NP
• Lisa A Baker, MD
• Christine Balestrieri
• Michele Baltus, MD
• Fanny Yvette Bandenay, MS SLP
• Rachelle Baptiste
• Maria Barrera
• Audrey Barrett

• All providers in Huntington Station, NY
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.