Provider Demographics
NPI:1235753500
Name:BALL, CORTNEY (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:BALL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 GREENWAY DR STE 360
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2447
Mailing Address - Country:US
Mailing Address - Phone:844-824-8775
Mailing Address - Fax:281-648-2200
Practice Address - Street 1:1425 GREENWAY DR STE 360
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-2447
Practice Address - Country:US
Practice Address - Phone:844-824-8775
Practice Address - Fax:281-648-2200
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401018879101YP2500X
TX89112101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional