Individual
RICHARD EARL BALLARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LPC AND LMFT
Contact information
Practice address
SITE OFFICE: CHARLES CARROLL MS 6130 LAMONT DRIVE, C/O MS. CLAUDIA B.-WALTER, FBCOG- CEO FOR SON RISE CC&I, NEW CARROLLTON, MD 20784
(301) 458-0578
Mailing address
SITE OFFICE: CHARLES CARROLL MS 6130 LAMONT DRIVE, C/O MS. CLAUDIA B.-WALTER, FBCOG- CEO, NEW CARROLLTON, MD 20784
(301) 458-0578
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PRC618
DC
106H00000X
Marriage & Family Therapist
Primary
LMFT000065
DC
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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