Emily A Ballantyne, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

42611 Issued in ID

Practice address

11513 W Fairview Ave Ste 105
Boise, ID 83713-7887

Phone

(209) 908-7882

NPI assigned

Aug 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Emily A Galego Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Avanzar Wellness LLC

  • Psychologist
  • Boise, ID
  • NPI 1871126797
  NPD (past)

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1902526999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11513 W FAIRVIEW AVE STE 105",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837137887",
            "telephone_number": "208-908-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11513 W FAIRVIEW AVE STE 105",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837137887",
            "telephone_number": "209-908-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLANTYNE",
        "first_name": "EMILY",
        "middle_name": "A",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "42611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "GALEGO",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joan E. Ball, RN, CNM
• Mary Elizabeth Ball, LCSW, ACADC
• Nakale Ball
• Shane K Ball, M.D.
• David Alan Ballance, MD
• Sarah Ballard, LCSW
• Brooke Taylor Ballenberg, LPC, NCC
• Elizabeth Balleweg
• Jay T. Ballhagen, M.D.
• Angeles L Ballou, FNP

• Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.