Provider Demographics
NPI:1215568449
Name:BALLARD, JULIE KATHERINE (LAPC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:KATHERINE
Last Name:BALLARD
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 CROSS CREEK DR SW
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-3774
Mailing Address - Country:US
Mailing Address - Phone:404-435-6940
Mailing Address - Fax:
Practice Address - Street 1:5205 STILESBORO RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7764
Practice Address - Country:US
Practice Address - Phone:678-278-8345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006806101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional