Provider Demographics
NPI:1033144993
Name:BALLUTE, JANET PALKO (LCSWR)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:PALKO
Last Name:BALLUTE
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:MS
Other - First Name:JANET
Other - Middle Name:ELIZABETH
Other - Last Name:PALKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:672 EAST ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-4110
Mailing Address - Country:US
Mailing Address - Phone:607-433-0037
Mailing Address - Fax:
Practice Address - Street 1:143 MAIN ST
Practice Address - Street 2:SUITE 221
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2501
Practice Address - Country:US
Practice Address - Phone:607-432-7174
Practice Address - Fax:607-432-7174
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0699511041C0700X
NY243968163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN2Y301Medicare ID - Type Unspecified