Theresa Ballas, LAC
Individual provider Active NPI Professional Counselor · Glassboro, NJ
NPI 1073069985 · NPPES record last updated Aug 31, 2016
Key facts
- NPI
- 1073069985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 37AC00300100 (NJ)
- Practice address
- 42 Delsea Dr S
Glassboro, NJ 08028-2621 - Phone
- (856) 881-8689
- Fax
- (856) 881-5508
- NPI assigned
- Aug 31, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101YP2500X | NJ | MD | Mental Health Counselor |
| 37AC00300100 | NJ | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37AC00300100 | NJ | Yes |
| Counselor | 101Y00000X | 101YP2500X | NJ |
Addresses
Primary practice location
42 Delsea Dr S
Glassboro, NJ 08028-2621
Mailing address
42 Delsea Dr S
Glassboro, NJ 08028-2621
Phone (856) 881-8689
Other providers in Glassboro, NJ
- Assoc. for Retarded Citizens, Inc. Gloucester County
- Assoc. for Retarded Citizens, Inc. Gloucester County
- Assoc. for Retarded Citizens, Inc. Gloucester County
- Assoc. for Retarded Citizens, Inc. Goucester County
- Backtometherapy LLC
- Bancroft, a New Jersey Nonprofit Corporation
- Claudia R Batten
- Briana Baud
- Jennifer Bayne
- Jaclyn Bechtler
All providers in Glassboro, NJ · Professional Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.