Erica Ballard Fernandez

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LGP10516 Issued in MD

Practice address

111 Warren Rd Ste 4a
Cockeysville, MD 21030-3366

Phone

(443) 595-7627

NPI assigned

Jul 5, 2022

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

Electronic endpoints 1

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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1386377745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WARREN RD STE 4A",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WARREN RD STE 4A",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303366",
            "telephone_number": "443-595-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ERICA",
        "middle_name": "BALLARD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP10516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "soap",
            "affiliation": "N",
            "endpointDescription": "client communication",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "111 Warren Rd Ste 4A",
            "city": "Cockeysville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210303366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Jennings Evans, DDS
• Evolution Sports Physiotherapy - White Marsh, LLC
• Evolution Sports Physiotherapy, Inc.
• Evolve Therapy LLC
• Matthew Clifton Farzin, D.D.S.
• Eva T Fiastro, D.D.S.
• Daniel Edward Fielding, DDS
• Kevin Edward Fielding, DDS
• Christine Anis Fil, CRNP
• First Step Inc

• Mental Health Counselor in Cockeysville, MD
• Providers in Cockeysville, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.