Amanda L Ballard, CSAC, SAC-IT, OT
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Janesville, WI
NPI 1851546667 · NPPES record last updated Jan 14, 2026
Key facts
- NPI
- 1851546667
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 17168-132 (WI)
- Practice address
- 2600 Humes Rd Ste 100
Janesville, WI 53545 - Phone
- (608) 741-2117
- NPI assigned
- Nov 20, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2008
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
29624 Network PL
Chicago, IL 60673-1296
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260313001653 | WI | Practitioner - Occupational Therapist in Private Practice | 6406919836 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17168-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 18847-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 5202-26 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health System Corporation | Current |
Accepting new patients | |
| Mercy Health System Corporation | Occupational Therapist | Current |
Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
2600 Humes Rd
Ste 100
Janesville, WI 53545
Phone (608) 741-2117
Interoperability endpoints
- aballard39434@direct.mhemail.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 18847-130 | WI | |
| Occupational Therapist | 225X00000X | 103657 | MN | |
| Occupational Therapist | 225X00000X | 5202-26 | WI | |
| Occupational Therapist | 225X00000X | 056008907 | IL | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 17168-132 | WI | Yes |
Addresses
Primary practice location
2600 Humes Rd Ste 100
Janesville, WI 53545
Mailing address
29624 Network PL
Chicago, IL 60673-1296
Other practice location 1
1401 E State St
Rockford, IL 61104-2315
Phone (779) 489-4595
Other practice location 2
4730 Squaw Prairie Rd
Belvidere, IL 61008-8800
Phone (815) 544-9495
Other practice location 3
200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ENROLLED | Medicaid | MN |
Other providers in Janesville, WI
- Linda Anne Bailey
- Susan King Baird
- Heidi Bakke
- Savannah Bakken
- Rajesh Balagani
- Norman Bambenek
- Madelynn J Bamford
- Orson Daniel Bangert
- Amy Banker
- Patrick John Baranowski
All providers in Janesville, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.