Jessica Balowski, LMSW
Individual provider Active NPI Clinical Social Worker · New Boston, MI
NPI 1497311476 · NPPES record last updated Apr 29, 2022
Key facts
- NPI
- 1497311476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801113508 (MI)
- Practice address
- 29915 West Road
New Boston, MI 48164 - Phone
- (734) 887-1124
- NPI assigned
- May 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801113508 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behind the Line, LC | Clinical | Current |
Accepting new patients |
| Michigan Clinical Research Institute PC | Past |
Accepting new patients | |
| Arman C. Moshyedi, MD, PLLC | Past | Accepting new patients |
Locations
26216 Gibraltar Rd
Unit 1072
Flat Rock, MI 48134
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801113508 | MI | Yes |
Addresses
Primary practice location
29915 West Road
New Boston, MI 48164
Mailing address
29915 West Rd
New Boston, MI 48164-9473
Phone (734) 642-7365
Other providers in New Boston, MI
- Rosalia E Aiello
- Arjan Medical PLLC
- Kimberly Ann Bailey
- Behind the Line, LC
- Andrue Bergmooser
- Roger Bradford
- Scott Allen Carey
- Lisa Mary Carter
All providers in New Boston, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2022. 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.