NPI 1063455863 · live from the CMS NPI Registry
Kay R Ballard, LPC, LMFT
Counselor, Professional in Oklahoma City, OK. National Provider Identifier 1063455863, active.
NPI record
| NPI | 1063455863 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Professional 101YP2500X |
| Practice location | 2212 Nw 50th St, Suite 172, Oklahoma City, OK 73112 |
| Practice phone | 405-640-8121 |
| Mailing address | Po Box 12883, Oklahoma City, OK 73157 |
| Enumerated | June 13, 2006 |
| Last updated | January 30, 2009 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional primary | 101YP2500X | 569 (OK) |
| Marriage & Family Therapist | 106H00000X | 1010 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.