MEDICARE: LAUREN BALL LCSW, LCADC, PLLC

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	133V00000X	Registered Dietitian
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1003535600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAUREN BALL LCSW, LCADC, PLLC

Provider Business Mailing Address
First Line	:	6840 BRIER CREEK LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4320
Country	:	US
Telephone Number	:	702-608-6421
Fax Number	:

Provider Business Practice Location Address
First Line	:	7310 SMOKE RANCH RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0258
Country	:	US
Telephone Number	:	702-608-6421
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAUREN BALL
Credential	:	LCSW, LCADC
Telephone Number	:	702-608-6421

Provider Enumeration Date	:	08/25/2022
Last Update Date	:	09/17/2022

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