Healthcare Provider Details

I. General information

NPI: 1356687867
Provider Name (Legal Business Name): KENNETH BALL MSW, BCBA, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2013
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 ALLEN ST
CARO MI
48723-1414
US

IV. Provider business mailing address

617 ALLEN ST
CARO MI
48723-1414
US

V. Phone/Fax

Practice location:
  • Phone: 989-529-1228
  • Fax:
Mailing address:
  • Phone: 989-529-1228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-16-22141
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: