Provider Demographics
NPI:1740513332
Name:BALLARD, RICHARD NEWMAN (LPCC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:NEWMAN
Last Name:BALLARD
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-3005
Mailing Address - Country:US
Mailing Address - Phone:502-523-4358
Mailing Address - Fax:502-894-4426
Practice Address - Street 1:3011 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-3005
Practice Address - Country:US
Practice Address - Phone:502-523-4358
Practice Address - Fax:502-894-4426
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0636101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor