Provider Demographics
NPI:1750137675
Name:KAILI BALL COUNSELING, LLC
Entity type:Organization
Organization Name:KAILI BALL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAILI
Authorized Official - Middle Name:
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-490-1437
Mailing Address - Street 1:9191 WALNUT GROVE DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-8370
Mailing Address - Country:US
Mailing Address - Phone:616-490-1437
Mailing Address - Fax:
Practice Address - Street 1:2450 44TH ST SE STE 302
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49512-9081
Practice Address - Country:US
Practice Address - Phone:616-805-9738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health