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NPI Code Detail

MEDICARE: MRS. TERESA LYNNE BALL LISW-CS

MEDICARE: MRS. TERESA LYNNE BALL LISW-CS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor902783OH
21041C0700XClinical Social WorkerCW013881PA
31041C0700XClinical Social WorkerI 0008726OH

General Provider Information

NPI Number : 1457591521
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERESA LYNNE BALL LISW-CS
Provider Business Mailing Address
First Line : 2863 STATE ROUTE 45 N
Second Line : GLENBEIGH
City : ROCK CREEK
State : OH
Zip : 44084-9352
Country : US
Telephone Number : 440-710-3222
Fax Number : 440-563-3206
Provider Business Practice Location Address
First Line : 2863 STATE ROUTE 45 N
Second Line :
City : ROCK CREEK
State : OH
Zip : 44084-9352
Country : US
Telephone Number : 440-710-3222
Fax Number : 440-563-3206
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2009
Last Update Date : 03/30/2017

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