Romeo Jesus Ballayan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

112627 Issued in TX

Practice address

2986 Chipper Dr NE
Palm Bay, FL 32905-5705

Phone

(347) 605-0462

NPI assigned

Feb 9, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shine Medical of Ca PC

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1942935473
  NPD (past)
• Vcounselors PLLC

  • Professional Counselor
  • San Antonio, TX
  • NPI 1326784307
  NPD (past)

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1679337653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 WYCLIFF AVE APT 3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192911",
            "telephone_number": "347-605-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2986 CHIPPER DR NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055705",
            "telephone_number": "347-605-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLAYAN",
        "first_name": "ROMEO",
        "middle_name": "JESUS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22595",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "112627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Babcock Dental Center
• Candy Ann Bailey, COTA
• Kizzie Bailey
• Laurie Kay Bailey, L.M.T.
• Paul Baldizzi, M.D.
• Brittany Bandy
• Richard Neil Baney, MD
• Nenar Barazi, DMD
• Luis J Barral
• Mary Rose Baes Barrios-Banal, M.D.

• Clinical Social Worker in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.