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NPI Code Detail

MEDICARE: ERIC ROBERT BALLEIN LPC

MEDICARE: ERIC ROBERT BALLEIN LPC
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
1101YP2500XProfessional CounselorE.2404615OH
2101YM0800XMental Health CounselorCP55929-RNV

General Provider Information

NPI Number : 1265205025
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC ROBERT BALLEIN LPC
Provider Business Mailing Address
First Line : 5373 PAINTED MIRAGE RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-0310
Country : US
Telephone Number : 937-554-4894
Fax Number :
Provider Business Practice Location Address
First Line : 8379 W SUNSET RD STE 140
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2248
Country : US
Telephone Number : 702-212-3008
Fax Number : 702-933-3064
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2023
Last Update Date : 02/14/2026

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