Thomas Vincent Ballard
Individual provider Active NPI Behavior Technician · Berlin, MD
NPI 1306374095 · NPPES record last updated May 25, 2017
Key facts
- NPI
- 1306374095
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 10514 Racetrack Rd Ste G
Berlin, MD 21811-3241 - Phone
- (410) 973-2371
- Fax
- (410) 973-2305
- NPI assigned
- May 25, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocean Front Counseling | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | MD | Yes |
Addresses
Primary practice location
10514 Racetrack Rd Ste G
Berlin, MD 21811-3241
Mailing address
10514 Racetrack Rd Ste G
Berlin, MD 21811-3241
Phone (410) 973-2371
Other providers in Berlin, MD
- Bobbi Lynn Bailey
- Deontae Bailey
- Joann Bailey
- Jossett Marcia Bailey
- Shardae Bailey
- Carly Banks
- Aimee Barnes
- Caitlin Barnwell
- Emily Rose Barry
- Caylee Barton
All providers in Berlin, MD · Behavior Technician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2017. 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.