Provider Demographics
NPI:1093427965
Name:BALL, LINDA SUE (LCPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
Last Name:BALL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46455 HYATT CT
Mailing Address - Street 2:
Mailing Address - City:DRAYDEN
Mailing Address - State:MD
Mailing Address - Zip Code:20630-3415
Mailing Address - Country:US
Mailing Address - Phone:240-925-0926
Mailing Address - Fax:
Practice Address - Street 1:22530 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-3898
Practice Address - Country:US
Practice Address - Phone:301-690-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC12912101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional