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NPI Code Detail

MEDICARE: MRS. LISA KAY BALLINGER

MEDICARE: MRS. LISA KAY BALLINGER
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
11041C0700XClinical Social Worker
2390200000XStudent in an Organized Health Care Education/Training ProgramS1700018-TRNEOH
3101YM0800XMental Health CounselorI.2405962OH

General Provider Information

NPI Number : 1033828884
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA KAY BALLINGER
Provider Business Mailing Address
First Line : 7185 HULLS CV
Second Line :
City : MENTOR
State : OH
Zip : 44060-5106
Country : US
Telephone Number : 440-488-6066
Fax Number : 440-953-6101
Provider Business Practice Location Address
First Line : 23366 COMMERCE PARK STE 100B
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5801
Country : US
Telephone Number : 216-292-2880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2022
Last Update Date : 11/06/2024

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