Carolee Kay Balliett

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.1302502 Issued in OH

Practice address

114 S Walnut St
Bucyrus, OH 44820-2324

Phone

(419) 562-2400

NPI assigned

May 24, 2013

Last updated

May 24, 2013By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Affinity Healthworks, LLC

  • Community/Behavioral Health Agency
  • Bucyrus, OH
  • NPI 1689248007
  NPD

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1356788707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 722",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448200722",
            "telephone_number": "419-562-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S WALNUT ST",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448202324",
            "telephone_number": "419-562-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLIETT",
        "first_name": "CAROLEE",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-24",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1302502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Camille Auck, C-NP
• Matthew Paul Axline, OD OPTOMETRIST
• B.T. Strick, P.a. (Maple Creek Medical)
• B&K Home Medical Services, Inc.
• Janelle Jean Baldosser, MSN-CNP
• Ramya Bangalore Jagadeesh, DDS
• Tonia Barlow
• Erin Bauer, OT
• Shanna Sue Bays
• Erik Beeler, PT

• Social Worker in Bucyrus, OH
• Providers in Bucyrus, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; 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.