Bryan Balaban, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

100 Straube Center Blvd
Pennington, NJ 08534-1468

Phone

(856) 630-5850

NPI assigned

Oct 5, 2018

Sex

Male

Sole proprietor

Yes

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

Enrolled in NJ

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Woods Psychotherapy Services, LLCGroup PAC ID 3476564873, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Practice roles

Locations

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.

• Woods Psychotherapy Services, LLC

  • Clinical Social Worker
  • Pennington, NJ
  • NPI 1841243854

  Clinical, NJ

  Medicare reassignment Care Compare group NPD
• Woods Psychotherapy Services LLC

  • Clinical Psychologist
  • Pennington, NJ
  • NPI 1790730901

  Clinical

  NPD (past)

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1861967804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 STONEHURST DR",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STRAUBE CENTER BLVD",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085341468",
            "telephone_number": "856-630-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALABAN",
        "first_name": "BRYAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Axiva Infusion Centers - PN LLC
• Arash Azhideh, MD, MPH, MBA
• Nancy Badilla-Monge
• Hyun Bae, M.D.
• Sina Bagheri, MD
• Anil R Balani, M.D.
• Tonita Balcom, PSY.D.
• Theresa Balestrieri, RD
• Felipe Tablan Banzon, MD
• Brian Barrett, M.D.

• All providers in Pennington, NJ
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.