Provider Demographics
NPI:1265132864
Name:BALL, MAYA LEIGH (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:MAYA
Middle Name:LEIGH
Last Name:BALL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5337 COACH WAY DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2303
Mailing Address - Country:US
Mailing Address - Phone:609-977-6772
Mailing Address - Fax:
Practice Address - Street 1:5337 COACH WAY DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2303
Practice Address - Country:US
Practice Address - Phone:609-977-6772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040149211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical