Provider Demographics
NPI:1568973162
Name:CARIC-BALL, CHRISTY IVANIA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:IVANIA
Last Name:CARIC-BALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 MICHAELANGELO DR STE 400
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-1405
Mailing Address - Country:US
Mailing Address - Phone:956-362-3590
Mailing Address - Fax:956-362-3598
Practice Address - Street 1:2821 MICHAELANGELO DR STE 400
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1405
Practice Address - Country:US
Practice Address - Phone:956-362-3590
Practice Address - Fax:956-362-3598
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75177101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3763674-01Medicaid