Provider Demographics
NPI:1902090848
Name:BALL, TAMMY L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:L
Last Name:BALL
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:1709 KY ROUTE 321
Mailing Address - Street 2:STE 3
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9097
Mailing Address - Country:US
Mailing Address - Phone:606-886-8546
Mailing Address - Fax:606-886-8548
Practice Address - Street 1:835 PARKWAY DRIVE
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-9250
Practice Address - Country:US
Practice Address - Phone:606-349-5126
Practice Address - Fax:606-349-5123
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY15221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical