Roger Ashman Ballou, PHD, LMFT, LPC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

723 Issued in WI

Practice address

2900 Thomas Ave S
Apartment 1526
Minneapolis, MN 55416-4477

Phone

(651) 246-7592

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1609959006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 THOMAS AVE S",
            "address_2": "APARTMENT 1526",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164477",
            "telephone_number": "651-246-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 THOMAS AVE S",
            "address_2": "APARTMENT 1526",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164477",
            "telephone_number": "651-246-7592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU",
        "first_name": "ROGER",
        "middle_name": "ASHMAN",
        "name_prefix": "Dr.",
        "credential": "PHD, LMFT, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "723",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1130",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NH",
            "license": "203",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annika Jean Ballantyne, MD
• Ballard Psychological Services LLC
• Ralph E. Ballard, R.PH., M.B.A.
• Jomark Abalos Ballesteros
• Andrew Richard Ballin, DDS
• Fabiola Balmir, M.D.
• David Young Balser, MD
• Danica Balsiger, MD
• Krystal Lauren Balster, OTR/L
• Susan Balto

• Marriage & Family Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.