Active NPI
Kristin Balon
- Psychologist
- La Porte, IN
National Provider Identifier
1982851796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20042448A
- Practice address
- 1230 W State Road 2
La Porte, IN 46350-5537 - Phone
- (219) 362-2145
- NPI assigned
- Aug 22, 2008
- Last updated
- Feb 18, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 20042448A | IN | Primary |
Addresses
Primary practice location
1230 W State Road 2
La Porte, IN 46350-5537
Mailing address
1230 W. State Road 2
La Porte, IN 46350
Phone (219) 362-2145
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100163580 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20042448A | IN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laporte County Comprehensive Mental Health Council | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Swanson Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Michigan City, IN
- NPI 1962375964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361145600000",
"number": "1982851796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 W. STATE ROAD 2",
"city": "LA PORTE",
"state": "IN",
"postal_code": "46350",
"telephone_number": "219-362-2145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 W STATE ROAD 2",
"city": "LA PORTE",
"state": "IN",
"postal_code": "463505537",
"telephone_number": "219-362-2145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALON",
"first_name": "KRISTIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-22",
"last_updated": "2013-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "20042448A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100163580",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Porte, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.