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Organization

THE BALLYBA CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL LEHMAN CONWAY MS LPCC (OWNER)
(320) 290-7330
Entity
Organization

Contact information

Practice address
333 WASHINGTON AVE N, MINNEAPOLIS, MN 55401-2263
(320) 290-7330
Mailing address
2709 PORTLAND AVE, MINNEAPOLIS, MN 55407-1020
(320) 290-7330

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
05/18/2026
Last updated
05/18/2026
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