Mark Alan Babula, PSY.D.
Individual provider Active NPI Clinical Psychologist · Toledo, OH
NPI 1831490564 · NPPES record last updated Aug 6, 2021
Key facts
- NPI
- 1831490564
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 6565 (OH)
- Practice address
- 5965 Renaissance PL Ste 1
Toledo, OH 43623-4728 - Phone
- (419) 882-5678
- Fax
- (419) 882-7446
- NPI assigned
- Nov 11, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230201000223 | OH | Practitioner - Psychologist Billing Independently | 1557543337 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Behavioral Healthcare Inc | Clinical | Current |
Accepting new patients |
Locations
5965 Renaissance Pl
Toledo, OH 43623
Phone (419) 882-5678
5965 Renaissance Pl
Ste 1
Toledo, OH 43623
Phone (419) 882-5678
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6565 | OH | Yes |
Addresses
Primary practice location
5965 Renaissance PL Ste 1
Toledo, OH 43623-4728
Mailing address
5965 Renaissance PL Ste 1
Toledo, OH 43623-4728
Phone (419) 882-5678
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.