Individual provider Active NPI

Brandee Bales, LISW

  • Clinical Social Worker
  • Athens, OH
National Provider Identifier
1801394465
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2203413 Issued in OH
Practice address
11 Graham Dr
Athens, OH 45701-1430
Phone
(740) 594-9967
Fax
(740) 594-9967
NPI assigned
Jan 30, 2018
Last updated
Apr 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1701403 OH
Clinical Social Worker 1041C0700X I.2203413 OH Primary

Addresses

Primary practice location

11 Graham Dr
Athens, OH 45701-1430

Mailing address

PO Box 132
Athens, OH 45701-0132
Phone (740) 594-6807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220414002444 OH Practitioner - Clinical Social Worker 8527454750 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1701403OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Services for Behavioral Health Clinical CurrentSince Feb 14, 2022 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Integrated Services for Behavioral Health PastSince Feb 14, 2022 Accepting new patients

Locations

11 Graham Dr
Athens, OH 45701
Phone (740) 594-6807

800 N High St
Columbus, OH 43215
Phone (631) 540-8225

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/isaoh/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1801394465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 132",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457010132",
            "telephone_number": "740-594-6807",
            "fax_number": "740-594-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GRAHAM DR",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011430",
            "telephone_number": "740-594-9967",
            "fax_number": "740-594-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALES",
        "first_name": "BRANDEE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-30",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1701403",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.