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General NPI Number Information
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NPI Number | 1134031719
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Entity Type | Individual
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Provider Name | MAXINE LLOYD BALL REV DR
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Gender | Female
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Dates
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Enumeration Date | 09/19/2026
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Last Update Date | 09/19/2026
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Provider Practice Location Address
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Address Line | 3017 OAK GREEN CT APT D
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-3524
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Country | US
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Telephone | 410-431-1114
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2621
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City | ELLICOTT CITY
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State | MD
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Zip | 21041-2621
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Country | US
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Telephone | 410-431-1114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC12400
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | LC12400
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License Number State | MD
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