Individual provider Active NPI

Shaquia Lashea Ballard, LMSW-C

  • Social Worker
  • Waterford, MI
National Provider Identifier
1245899681
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801122022 Issued in MI
Practice address
4000 W Walton Blvd
Waterford, MI 48329-4191
Phone
(248) 461-6304
NPI assigned
Jun 10, 2019
Last updated
Apr 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801122022 MI Primary

Addresses

Primary practice location

4000 W Walton Blvd
Waterford, MI 48329-4191

Mailing address

4000 W Walton Blvd
Waterford, MI 48329-4191
Phone (248) 461-6266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20260527003346 MI Practitioner - Clinical Social Worker 0244700680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4000 W Walton Blvd
Suite B
Waterford, MI 48329-4191

885 Penniman Ave
Unit 5425
Plymouth, MI 48170-7729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801122022MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelens Psychological and Counseling Services CurrentSince Apr 3, 2026 Accepting new patients

Locations

4000 W Walton Blvd
Ste B
Waterford, MI 48329
Phone (248) 461-6266

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1245899681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294191",
            "telephone_number": "248-461-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294191",
            "telephone_number": "248-461-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "SHAQUIA",
        "middle_name": "LASHEA",
        "credential": "LMSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801122022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.