Provider Demographics
NPI:1205122124
Name:BALL, SABRA SUSANNE
Entity type:Individual
Prefix:
First Name:SABRA
Middle Name:SUSANNE
Last Name:BALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 16708
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28816-0708
Mailing Address - Country:US
Mailing Address - Phone:828-254-5356
Mailing Address - Fax:828-259-5384
Practice Address - Street 1:2 COMPTON DRIVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2054
Practice Address - Country:US
Practice Address - Phone:828-254-5356
Practice Address - Fax:828-259-5384
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS1822101YA0400X
NC1822101YA0400X
NCC0078131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)