Provider Demographics
NPI:1407516347
Name:BALL, ALEXA G
Entity Type:Individual
Prefix:MS
First Name:ALEXA
Middle Name:G
Last Name:BALL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALEXA
Other - Middle Name:G
Other - Last Name:BALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:160 W 86TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4018
Mailing Address - Country:US
Mailing Address - Phone:212-362-8755
Mailing Address - Fax:
Practice Address - Street 1:160 W 86TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4018
Practice Address - Country:US
Practice Address - Phone:212-362-8755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist