Mary Upchurch Ballard, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C001352 Issued in NC

Practice address

1401 Park Avenue
Promise Place
New Bern, NC 28560

Phone

(252) 636-3381

Fax

(252) 636-2278

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Child & Family Psychological Consultants, P.a.

  • Clinical Psychologist
  • New Bern, NC
  • NPI 1093884819
  NPD (past)
• Promise Place

  • Voluntary or Charitable Agency
  • New Bern, NC
  • NPI 1972771525
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1679526461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 PARK AVENUE",
            "address_2": "PROMISE PLACE",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "28560",
            "telephone_number": "252-636-3381",
            "fax_number": "252-636-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PARK AVENUE",
            "address_2": "PROMISE PLACE",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "28560",
            "telephone_number": "252-636-3381",
            "fax_number": "252-636-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "MARY",
        "middle_name": "UPCHURCH",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12821",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003498",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Marie Baker
• Wendy Lynne Baker, LCSW
• Abigail Ballance
• Djanell Ballard
• Harry Hampton Ballard, M.D.
• Jennifer Ballinger, MD
• Lisa E Banker, MD
• Millard F Banker IV, MD
• Karen Banks
• Valerie Banning, DPT

• Clinical Social Worker in New Bern, NC
• Providers in New Bern, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.