Provider Demographics
NPI:1306391867
Name:BALL, DANIEL L (LCSW, LCAS, CCS, QS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:L
Last Name:BALL
Suffix:
Gender:M
Credentials:LCSW, LCAS, CCS, QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300-110 SAPPHIRE COURT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834
Mailing Address - Country:US
Mailing Address - Phone:252-830-7540
Mailing Address - Fax:
Practice Address - Street 1:3715 GUARDIAN AVE
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4323
Practice Address - Country:US
Practice Address - Phone:252-222-3144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-21989101YA0400X
NCP0108821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)