Dia Ballou
Individual provider Active NPI Clinical Social Worker · Claremont, NH
NPI 1346649142 · NPPES record last updated Aug 18, 2014
Key facts
- NPI
- 1346649142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 122 Pleasant St
Claremont, NH 03743-2679 - Phone
- (603) 542-5449
- NPI assigned
- Aug 18, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West Central Services, Inc.
Practice addresses (Care Compare)
85 Mechanic St
Lebanon, NH 03766-1537
Phone (603) 448-0126
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240409001643 | NH | Practitioner - Mental Health Counselor | 7618315771 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1246 | NH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Central Services, Inc. | Current |
Accepting new patients | |
| West Central Services, Inc | Past | Accepting new patients |
Locations
52 W Pleasant St
Claremont, NH 03743
Phone (603) 448-0126
85 Mechanic St
Lebanon, NH 03766
Phone (603) 448-0126
85 Mechanic St
Ste C21
Lebanon, NH 03766
9 Hanover St
#2
Lebanon, NH 03766
Phone (603) 448-0126
85 Mechanic St
Unit A10
Lebanon, NH 03766
Phone (603) 448-0126
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
122 Pleasant St
Claremont, NH 03743-2679
Mailing address
9 Hanover St
Suite 2
Lebanon, NH 03766-1312
Phone (603) 448-0126
Other providers in Claremont, NH
- Zuha Bajwa
- Erik Baker
- Suellen Tucker Balestra
- Todd Balise
- William J Ballantyne
- Bannon Pharmacy Inc
- Carl Jay Bannon
- Roy M Barnes
- Juliann Barrett
- Gwendolyn Jane Barros
All providers in Claremont, NH · Clinical Social Worker in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.