MS. TONI MARIE BALLAS-ROWE LCSW
NPI 1124027537
Social Worker - Clinical in Lewes, DE

Active since July 18, 2005PECOS EnrolledAccepts Medicare Assignment
16529 COASTAL HWY UNIT 120, LEWES, DE 19958(302) 645-0633(302) 226-8681 Get Directions Write a Review

NPPES record last updated: October 23, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 23, 2020, Apr 24, 2019, Feb 6, 2019 (3 updates tracked since 2019).

About Ms. Toni Marie Ballas-rowe Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. TONI MARIE BALLAS-ROWE LCSW (NPI 1124027537) is an individual clinical provider in Lewes, Delaware, licensed in Delaware (Q10000204) and active in the NPI registry since July 2005. She is enrolled in Medicare PECOS and is a graduate of Other (1983).

NPPES Registry Identity

NPI1124027537
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. TONI MARIE BALLAS-ROWECredential: LCSW
Location Address16529 COASTAL HWY UNIT 120Lewes, DE 19958-3697
Mailing AddressPo Box 681Lewes, DE 19958-0681 · (302) 645-0633 · Fax (302) 226-8681
Fax(302) 226-8681
Sole ProprietorNo
Medical School CMSOtherGraduated 1983
Enumeration DateJuly 18, 2005
Last NPPES UpdateOctober 23, 20203 updates tracked since enumeration
NPPES CertifiedOctober 23, 2020
NPI 1124027537 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in DE · Q10000204
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedCounselorTaxonomy 101Y00000X · License Q10000204 (DE)
16529 COASTAL HWY UNIT 120, Lewes, DE 19958

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Toni Marie Ballas-rowe Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133243223
PECOS Enrollment IDI20100826000262
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
358 services42 patients
Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
21 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19958 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $57.12 – $173.08
Typical copayment $0.00 (range $14.28 – $43.27)
Most-billed visit code NA
Established Patient
$71.19 typical visit price
range $18.36 – $141.05
Typical copayment $17.79 (range $4.59 – $35.26)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
16529 COASTAL HWY UNIT 120
LEWES, DE 19958
Counselor (Mental Health)
16529 COASTAL HWY UNIT 120
LEWES, DE 19958
Counselor (Mental Health)
16529 COASTAL HWY UNIT 120
LEWES, DE 19958
Social Worker (Clinical)
16529 COASTAL HWY UNIT 120
LEWES, DE 19958

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Toni Ballas-rowe's NPI number?

The NPI number for Toni Ballas-rowe is 1124027537. It was assigned to this individual provider in the NPPES registry on July 18, 2005.

Where is Toni Ballas-rowe located?

Toni Ballas-rowe practices at 16529 Coastal Hwy Unit 120, Lewes, DE 19958. The listed phone number is (302) 645-0633.

What is Toni Ballas-rowe's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Toni Ballas-rowe enrolled in Medicare?

Yes. Toni Ballas-rowe is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Toni Ballas-rowe accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 3 other insurers list Toni Ballas-rowe as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Toni Ballas-rowe was last updated on October 23, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.