Provider Demographics
NPI:1881359289
Name:BALLARD, AMBER WALKER (LCMHCA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:WALKER
Last Name:BALLARD
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 S ASHE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-3427
Mailing Address - Country:US
Mailing Address - Phone:704-915-2213
Mailing Address - Fax:
Practice Address - Street 1:120 2ND AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5011
Practice Address - Country:US
Practice Address - Phone:828-409-6743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16042101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health