Susan J. Ballard, L.I.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113142 Issued in MA

Practice address

632 Westfield St
West Springfield, MA 01089-3887

Phone

(413) 231-3094

Fax

(413) 455-1265

NPI assigned

Mar 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Child Guidance Clinic, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Manchester, CT
  • NPI 1780730267
  NPD (past)

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144359456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 POPLAR AVE",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010892925",
            "telephone_number": "413-231-3094",
            "fax_number": "413-455-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 WESTFIELD ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010893887",
            "telephone_number": "413-231-3094",
            "fax_number": "413-455-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "SUSAN",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113142",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005058",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PROVIDER ID",
            "identifier": "403426",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "3248367",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11241180",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Babagoro Babar
• Sarah Babbs Caress
• Sylvia Bachand
• Stephanie Ann Baird Sr., MS, LMHC
• Barbie A Baker
• Zlata Banar
• Tana Bao, MSN FNP-BC NP-C APRN
• Michael Baran, COTA
• Daniel Barbash, DO
• Mary C Barbato, CNS

• Clinical Social Worker in West Springfield, MA
• Providers in West Springfield, MA by specialty
• Clinical Social Worker in Massachusetts

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.