Mark Ballou Jr., MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12075 Issued in FL

Practice address

790 Veterans Way
Pensacola, FL 32507-1000

Phone

(850) 912-2000

NPI assigned

Oct 27, 2014

Last updated

Oct 27, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1255736856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 VETERANS WAY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325071000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 VETERANS WAY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325071000",
            "telephone_number": "850-912-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU",
        "first_name": "MARK",
        "name_suffix": "Jr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "12075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Lynn Baldwin, RN
• Micah Baldwin, LMT
• Michele Colene Balkom, ARNP
• Jason Ballard
• Kristen Rushell Ballard, ARNP
• Daniel Joseph Ballow, M.D.
• Thomas John Baltz Jr., P.T.
• Luzviminda Banares
• Murali Krishna Bandarupalli
• David Joshua Banet

• Clinical Social Worker in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.