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NPI Code Detail

MEDICARE: MRS. JENNIFER M BALL LCSW

MEDICARE: MRS. JENNIFER M BALL LCSW
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 Worker2021042801MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12021042801OTHERMOLCSW

General Provider Information

NPI Number : 1891119335
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER M BALL LCSW
Provider Business Mailing Address
First Line : 400 N 5TH ST STE 201
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-1808
Country : US
Telephone Number : 636-238-2615
Fax Number :
Provider Business Practice Location Address
First Line : 255 SPENCER RD STE 101
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-2574
Country : US
Telephone Number : 636-477-6111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2014
Last Update Date : 10/03/2024

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