Constance Marilyn Balcom, APSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

126627 Issued in WI

Practice address

10012 W Capitol Dr
Milwaukee, WI 53222-1338

Phone

(414) 810-4844

NPI assigned

Jul 20, 2021

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)

Not 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 and National Provider Directory roles.

• West Grove Clinic, SC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wauwatosa, WI
  • NPI 1518167477

  Single Specialty

  NPD

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1508439399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221338",
            "telephone_number": "414-810-4844",
            "fax_number": "414-810-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221338",
            "telephone_number": "414-810-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALCOM",
        "first_name": "CONSTANCE",
        "middle_name": "MARILYN",
        "credential": "APSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "WI",
            "license": "126627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Balaban-Feld, MD
• Binod Balakrishnan, MD
• Vetrivel Balakrishnan, M.D.
• Balanced Mental Health and Wellness LLC
• Gokulakrishnan Balasubramanian, M.D.
• Danielle Marie Bald, APSW, MSW
• Katie Jane Balderas, PA-C
• Priscilla Balderas, OTR
• Angel Danielle Baldwin, RN
• Antoinette Baldwin

• Social Worker in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.