Provider Demographics
NPI:1144395351
Name:BALLARD, BARBARA (NCC,LPC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:BALLARD
Suffix:
Gender:F
Credentials:NCC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11965 RED BARN CT
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-7830
Mailing Address - Country:US
Mailing Address - Phone:314-355-0509
Mailing Address - Fax:314-355-0509
Practice Address - Street 1:11650 NEW HALLS FERRY RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6924
Practice Address - Country:US
Practice Address - Phone:314-537-7637
Practice Address - Fax:314-355-0509
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001023748101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1-10SMZOtherINSURANCE CO.
CA377749OtherINSURANCE CO.
KY11563857OtherUNIVERSAL CREDENTIALING
MO209978OtherBLUE CROSS AND BLUE SHIEL