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General NPI Number Information
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NPI Number | 1861291163
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Entity Type | Individual
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Provider Name | NACOLE BALLARD LAPC, NCC, CTP
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Gender | Female
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 10393 FORD AVE BLDG C2ND
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City | RICHMOND HILL
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State | GA
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Zip | 31324-8811
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Country | US
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Telephone | 770-733-0635
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Fax |
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Provider Business Mailing Address
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Address Line | 138 CANAL ST STE 303
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City | POOLER
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State | GA
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Zip | 31322-4046
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Country | US
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Telephone | 912-433-7829
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | APC010238
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License Number State | GA
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