Michael S Balliro, LCSW

Individual provider Active NPI Clinical Social Worker · Dover, DE

NPI 1568028025 · NPPES record last updated May 10, 2019

Key facts

NPI
1568028025
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
Q1-0001671 (DE)
Practice address
642 S Queen St Ste 102
Dover, DE 19904-3506
Phone
(800) 818-8680
Fax
(800) 818-8680
NPI assigned
May 10, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
Q1-0001671DEMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Q1-0001671 DE Yes

Addresses

Primary practice location

642 S Queen St Ste 102
Dover, DE 19904-3506

Mailing address

1000 Midway Dr Ste 3
Harrington, DE 19952-2448
Phone (800) 818-8680

Other providers in Dover, DE

All providers in Dover, DE · Clinical Social Worker in Delaware

Sources for this page

Verify at the official NPI Registry.