Provider Demographics
NPI:1093041840
Name:JORDAHL-BALL, JILL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:
Last Name:JORDAHL-BALL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 LINCOLN WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-8534
Mailing Address - Country:US
Mailing Address - Phone:515-292-9251
Mailing Address - Fax:844-895-6179
Practice Address - Street 1:3510 LINCOLN WAY STE 300
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-8534
Practice Address - Country:US
Practice Address - Phone:515-292-9251
Practice Address - Fax:844-895-6179
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IA001168103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0069468Medicaid