Allyssa June Ballard, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801105497 Issued in MI

Practice address

4370 Chicago Dr SW # 515
Grandville, MI 49418-1694

Phone

(586) 585-6551

NPI assigned

Nov 10, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lyza June Ballard Professional name

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

Medicare enrollment (NPD)

Enrolled

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.

• Mas Counseling Services, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beverly Hills, MI
  • NPI 1912309352

  Clinical, MI

  Medicare reassignment NPD
• Suppression Expression Counseling, LLC

  • Mental Health Counselor
  • Grandville, MI
  • NPI 1811641855

  MI

  Medicare reassignment NPD
• Medical Village Optical Shoppe Inc

  • Optometrist
  • Beverly Hills, MI
  • NPI 1073572962
  NPD (past)

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

{
    "created_epoch": "1573344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1669017067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15611 CHESTNUT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480212392",
            "telephone_number": "616-723-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 CHICAGO DR SW # 515",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181694",
            "telephone_number": "586-585-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "ALLYSSA",
        "middle_name": "JUNE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYZA",
            "last_name": "BALLARD",
            "middle_name": "JUNE",
            "credential": "LMSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Margaret Elizabeth Bader, FNP
• Autumn N Bahlke, LMT
• Aaron Bailey, MSPT
• Olivia Baker, SLP
• Nancy Baldus, LLP, LPC
• Maribeth Anderson Bangert, O.D.
• Hannah Elizabeth Barnes, RN
• Shelby Barnes
• Jennifer Balangue Barnett
• Emily Jean Barnhart, DDS

• All providers in Grandville, MI
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.