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NPI Code Detail

MEDICARE: TONYA BALLARD LCSW

MEDICARE: TONYA BALLARD LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker1677KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346272044
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONYA BALLARD LCSW
Provider Business Mailing Address
First Line : 608 HAPPY VALLEY RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1561
Country : US
Telephone Number : 270-901-5000
Fax Number : 270-842-5268
Provider Business Practice Location Address
First Line : 608 HAPPY VALLEY RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1561
Country : US
Telephone Number : 270-901-5000
Fax Number : 270-842-5268
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 07/02/2008

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Directions to “ TONYA BALLARD LCSW” Practice Location

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