Organization Active NPI

Lutissua D Ballard, PSYD PLLC

  • Clinical Psychologist
  • Green Valley, AZ
National Provider Identifier
1366352189
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
LUTISSUA D BALLARD, PSYD PLLC
Practice address
210 W Continental Rd Ste 299
Green Valley, AZ 85622-3595
Phone
(520) 329-1579
NPI assigned
Sep 11, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Authorized official

Name
Dr. Lutissua D Ballard, PSYD
Title
Owner/Clinical Psychologist
Phone
(520) 329-1579

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

210 W Continental Rd Ste 299
Green Valley, AZ 85622-3595

Mailing address

PO Box 204
Fort Mill, SC 29716-0204
Phone (520) 329-1579

Other names 1

  • Shefa Life Counseling Center Doing business as

NPI Registry JSON

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

{
    "created_epoch": "1789084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1366352189",
    "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 299",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856223595",
            "telephone_number": "520-329-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTISSUA D BALLARD, PSYD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-11",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "BALLARD",
        "authorized_official_first_name": "LUTISSUA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "520-329-1579",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shefa Life Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.