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NPI Code Detail

MEDICARE: MR. MICHAEL BALLARD M.A., N.C.C

MEDICARE: MR. MICHAEL BALLARD M.A., N.C.C
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1013091842
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL BALLARD M.A., N.C.C
Provider Business Mailing Address
First Line : 11059 E BETHANY DR
Second Line : SUITE 200
City : AURORA
State : CO
Zip : 80014-2622
Country : US
Telephone Number : 303-617-2397
Fax Number : 303-617-2397
Provider Business Practice Location Address
First Line : 14301 E HAMPDEN AVE
Second Line :
City : AURORA
State : CO
Zip : 80014-3902
Country : US
Telephone Number : 303-617-2803
Fax Number : 303-617-2604
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 09/08/2008

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