Provider Demographics
NPI:1265899462
Name:BALLARD, AMY (LPC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BALLARD
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 1:10800 FINANCIAL CENTRE PKWY
Mailing Address - Street 2:SUITE 290
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3552
Mailing Address - Country:US
Mailing Address - Phone:501-781-2230
Mailing Address - Fax:888-816-7916
Practice Address - Street 1:10800 FINANCIAL CENTRE PKWY
Practice Address - Street 2:SUITE 290
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3552
Practice Address - Country:US
Practice Address - Phone:501-781-2230
Practice Address - Fax:888-816-7916
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2020-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA0803022101Y00000X
ARP1702249101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor