Doctor Name: | MR. JOHN MICHAEL BALL |
NPI Number: | 1558499269 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LSW 0000004412 |
Business Practice Address: | 12124 Highway 52 W Westmoreland, TN - 371863245 |
Business Phone Number: | 6156442000 |
Business Fax Number: | 6156442078 |
Mailing Address: | 12124 Highway 52 W, WESTMORELAND |
State: | TN |
Postal Code: | 371863245 |
Phone Number: | 6156442000 |
Fax Number: | 6156442078 |
NPI Enumeration Date: | 03/02/2007 |
NPI Last Update Date: | 05/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LSW 0000004412 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |