Shawna Bally, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

117890 Issued in CA

Practice address

141 Aptos Village Way Unit 202
Aptos, CA 95003-4143

Phone

(831) 316-3001

NPI assigned

Aug 20, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1780417469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950630022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 APTOS VILLAGE WAY UNIT 202",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "950034143",
            "telephone_number": "831-316-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLY",
        "first_name": "SHAWNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "117890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Avila, R.N.
• Azevedo Inc Dba the Pathway Program
• Carolyn Jean Bailey
• Elyse Rochelle Bainbridge, PA-C
• Elizabeth Ballew, PHARMD
• Alexander Barber, BCBA
• Kimberly Ann Barry, PT
• Thomas Edward Bastasch, LMFT
• Deborah Sue Bates, LMFT
• Lance Bauscher, MFT

• Social Worker in Aptos, CA
• Providers in Aptos, CA by specialty
• Social Worker in California

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