Traci Denise Ballard, MA, MPA, LLPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401016840 Issued in MI

Practice address

79 W Alexandrine St
Detroit, MI 48201-2015

Phone

(313) 831-5535

Fax

(313) 831-2608

NPI assigned

Aug 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Mental Health Counselor

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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

• Art of Healing Behavioral Services, P.L.L.C.

  • Mental Health Counselor
  • Farmington Hills, MI
  • NPI 1003569146
  NPD Authorized official
• Grady Memorial Hospital Corporation

  dba Grady Health System

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1114243813
  Medicare reassignment
• Team Mental Health Services Inc.

  dba Team Wellness Center

  • Primary Care Clinic/Center
  • Detroit, MI
  • NPI 1295324291
  NPD
• Team Wellness Center

  • Community Health Clinic/Center
  • Detroit, MI
  • NPI 1588855100
  NPD

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581724800000",
    "number": "1336695733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-831-5535",
            "fax_number": "313-831-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-831-5535",
            "fax_number": "313-831-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "TRACI",
        "middle_name": "DENISE",
        "credential": "MA, MPA, LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2020-02-15",
        "certification_date": "2020-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401016840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinne Ballard, MD
• Mareshah Ballard
• Pearline Ballard, SOCIAL WORKER
• Ronald Ballard, PA
• Takara Joelle Ballard
• William David Ballew
• John George Ballouz, DDS
• Antonia Balmaceda, LLMSW
• Richard Balon, MD
• Nancy Marie Balowski

• Mental Health Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2020; 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.