Provider Demographics
NPI:1508654658
Name:BALLEN, KATE MARION (LMSW)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:MARION
Last Name:BALLEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1148 5TH AVE APT 12C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0807
Mailing Address - Country:US
Mailing Address - Phone:917-561-9181
Mailing Address - Fax:
Practice Address - Street 1:18 E 48TH ST RM 1102
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1059
Practice Address - Country:US
Practice Address - Phone:646-480-9581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY126799-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker