Provider Demographics
NPI:1326682196
Name:SCOTT, DANIELLE CHERIE BALLIS (LPC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CHERIE BALLIS
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:CHERIE
Other - Last Name:BALLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18609 DRY POND DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5546
Mailing Address - Country:US
Mailing Address - Phone:512-270-1918
Mailing Address - Fax:
Practice Address - Street 1:18609 DRY POND DR
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-5546
Practice Address - Country:US
Practice Address - Phone:512-270-1918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78426101Y00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1326682196Medicaid