Provider Demographics
NPI:1598352445
Name:BALESTRINO, BARBARA A
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:BALESTRINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-1327
Mailing Address - Country:US
Mailing Address - Phone:330-509-3957
Mailing Address - Fax:
Practice Address - Street 1:1154 CHEROKEE DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44511-1327
Practice Address - Country:US
Practice Address - Phone:330-509-3957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-27
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH108258954899Medicaid