Healthcare Provider Details

I. General information

NPI: 1003535600
Provider Name (Legal Business Name): LAUREN BALL LCSW, LCADC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 09/17/2022
Certification Date: 09/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7310 SMOKE RANCH RD
LAS VEGAS NV
89128-0258
US

IV. Provider business mailing address

6840 BRIER CREEK LN
LAS VEGAS NV
89131-4320
US

V. Phone/Fax

Practice location:
  • Phone: 702-608-6421
  • Fax:
Mailing address:
  • Phone: 702-608-6421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: LAUREN BALL
Title or Position: OWNER
Credential: LCSW, LCADC
Phone: 702-608-6421