MEDICARE: DONNA BALLENGER MFT

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
1	106H00000X	Marriage & Family Therapist	10644	SC

General Provider Information

NPI Number	:	1689543639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA BALLENGER MFT

Provider Business Mailing Address
First Line	:	1754 WOODRUFF RD # 146
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-5933
Country	:	US
Telephone Number	:	973-704-1602
Fax Number	:	973-704-1602

Provider Business Practice Location Address
First Line	:	108 AIRPORT RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-2607
Country	:	US
Telephone Number	:	973-704-1602
Fax Number	:	973-704-1602

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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Directions to “ DONNA BALLENGER MFT” Practice Location

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