Provider Demographics
NPI:1245459346
Name:BALLARD, B CARL (LPC)
Entity type:Individual
Prefix:
First Name:B
Middle Name:CARL
Last Name:BALLARD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10318 SPARROW HAWK WAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-5672
Mailing Address - Country:US
Mailing Address - Phone:303-916-2900
Mailing Address - Fax:303-470-2800
Practice Address - Street 1:10318 SPARROW HAWK WAY
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-5672
Practice Address - Country:US
Practice Address - Phone:303-916-2900
Practice Address - Fax:303-470-2800
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO773101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional