MEDICARE: ABBY BALLENTINE BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1467004119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY BALLENTINE BCBA

Provider Business Mailing Address
First Line	:	7108 SOUTH KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 SOUTH MAIN ST
Second Line	:	1ST FLOOR
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2923
Country	:	US
Telephone Number	:	864-505-3234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2019
Last Update Date	:	12/08/2025

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Directions to “ ABBY BALLENTINE BCBA” Practice Location

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