Lutissua D Ballard, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4480 Issued in AZ

Practice address

210 W Continental Rd Ste 229
Green Valley, AZ 85622-3596

Phone

(520) 329-1579

NPI assigned

Apr 22, 2014

Last updated

Aug 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lutissua D Ballard, PSYD PLLC

  dba Shefa Life Counseling Center

  • Clinical Psychologist
  • Green Valley, AZ
  • NPI 1366352189
  NPD (past) Authorized official
• Pool of Bethesda Psychiatric Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Surprise, AZ
  • NPI 1881240760
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1093135659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 204",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297160204",
            "telephone_number": "520-329-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W CONTINENTAL RD STE 229",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856223596",
            "telephone_number": "520-329-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "LUTISSUA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4480",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AZ",
            "license": "4480",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "914097",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z194557",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Athlon Physical Therapy, LLC (Movement For Life Physical Therapy)
• Elizabeth Mable Augustine, DPT
• Carol Avila, ACNP
• Katelyn Ayer, MA SLP CCC
• Cynthia Babcock Sullivan
• Elisa Ycoco Ballesteros, BS SLP
• Banner - University Medical Center Tucson Campus LLC
• Barnet Dulaney Perkins Eye Center, PC (American Vision Partners)
• Barney D. Streit, D.D.S., P.C.
• Kevin David Barrow, LPC

• Clinical Psychologist in Green Valley, AZ
• Providers in Green Valley, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.