LUTISSUA D BALLARD (NPI# 1093135659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093135659 |
| Entity Type | Individual |
| Full Name | LUTISSUA D BALLARD |
| Credential | PSYD |
| Practice Address |
5930 E Pima St Suite 200 Tucson AZ 85712-4370 |
| Mailing Address |
5930 E Pima St Ste 200 Tucson AZ 85712-4370 |
| Practice Telephone | 5203291579 |
| Mailing Telephone | 5203291579 |
| Mailing Fax Number | 5203333107 |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2016-09-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
4480 | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 914097 | 05 |
| Street Address |
5930 E PIMA ST SUITE 200 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85712-4370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033105069 | Cheryl Weinert Martin | Counselor | 5930 E Pima St, Ste 100, Tucson, AZ 85712-4370 | 2005-09-26 |
| 1255617205 | Alexis Grae | Counselor | 5930 E Pima St, Suite 208, Tucson, AZ 85712-4370 | 2011-10-21 |
| 1518166529 | Carrie Freedheim Md Pllc | Psychiatry & Neurology | 5930 E Pima St, Suite 130, Tucson, AZ 85712-4370 | 2007-07-11 |
| 1093916173 | Alfred W. Wiggins | Psychologist | 5930 E Pima St, Suite 200, Tucson, AZ 85712-4370 | 2007-05-29 |
| 1265572853 | James C Rau | Clinical Neuropsychologist | 5930 E Pima St, Suite 124, Tucson, AZ 85712-4370 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104950 | Nancy Rae Klug | Registered Nurse | 2380 N Ferguson Ave., Tucson, AZ 85712 | 2020-08-12 |
| 1013525534 | James Tutu Fiske I | Nurse Practitioner | 5700 E. Pima Street Suite C., Tucson, AZ 85712 | 2020-07-21 |
| 1063031953 | Mehera Tiffanie Hormuz | Student in an Organized Health Care Education/Training Program | 5301 E. Grant Rd., Tucson, AZ 85712 | 2020-04-10 |
| 1770133282 | Elizabeth Nadeschzda Lowell | Nurse Practitioner | 4881 E Grant Road, Suite 101, Tucson, AZ 85712 | 2019-09-17 |
| 1174185649 | Pisa Asc Holdco LLC | Clinic/Center | 4741 E Camp Lowell Drive, Tucson, AZ 85712 | 2019-07-03 |
| 1548821838 | Painted Sky Healthcare, Inc. | Hospice Care, Community Based | 2980 N Swan Rd Ste 222, Tucson, AZ 85712 | 2019-06-26 |
| 1558925644 | Helen Jane Lyall | Registered Nurse | Tucson Medical Centre, 5301 E Grant Road, Tucson, AZ 85712 | 2019-04-24 |
| 1760953541 | Anna Marissa Ramirez | Nurse Practitioner | 5170 E Glenn St Ste 160, Tucson, AZ 85712 | 2018-12-05 |
| 1407343841 | Imran Ata Md Pllc | Internal Medicine | 3925 E Fort Lowell Rd Ste 105, Tucson, AZ 85712 | 2018-04-20 |
| 1003322926 | Millennium Acupuncture | Acupuncturist | 6161 E Pima St Tucson Az 85712, Apt 2074, Tucson, AZ 85712 | 2017-12-15 |
| Find all providers in zip 85712 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154475648 | Kathleen Campbell | Psychologist | 4550 E 5th St, Tucson, AZ 85711-7004 | 2007-01-22 |
| 1306367016 | Jerone I Smith Sr. | Psychologist | 6280 E Pima St Ste 100, Tucson, AZ 85712-3074 | 2017-07-03 |
| 1407923949 | Brenda M Sparrold | Psychologist | 2225 E Ajo Way, Tucson, AZ 85713-6201 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202594 | Olugus Family Care | Psychologist | 44077 W. Palmen Dr., Maricopa, AZ 85138 | 2020-10-15 |
| 1972029205 | Prism Learning and Development, Pllc | Psychologist | 7157 E Rancho Vista Dr Ste 7147b24, Scottsdale, AZ 85251-1494 | 2017-08-18 |
| 1477928471 | Erin Testa | Psychologist | 7600 N 16th St Ste 218, Phoenix, AZ 85020 | 2015-12-02 |
| 1811360316 | Redemption Psychiatry LLC | Psychologist | 2730 S Val Vista Dr Ste 137, Gilbert, AZ 85295-1681 | 2015-11-05 |
| 1447582937 | Shefali Gandhi, Psy.d., P.l.l.c. | Psychologist | 7120 E 6th Ave, Suite 20, Scottsdale, AZ 85251-3228 | 2010-02-08 |
| 1306077979 | Sue R Lerner | Psychologist | 6773 E Gelding Dr, Scottsdale, AZ 85254-3494 | 2009-07-30 |
| 1417137274 | Cathy Lynn Bissett | Psychologist | 24654 N Lake Pleasant Pkwy Ste 103-497, Peoria, AZ 85383-1359 | 2007-11-09 |
| 1982890588 | Erin Keely Lanphier | Psychologist | 21807 N Scottsdale Rd, Scottsdale, AZ 85255-7439 | 2007-09-18 |
| 1396966453 | Larry L. Grimm | Psychologist | 222 S. Summit Ave., Ste. 1, Prescott, AZ 86303-3780 | 2007-05-02 |
| 1801919840 | Tyra Maria Ripley | Psychologist | 3120 W Cholla St, Phoenix, AZ 85029-4113 | 2007-04-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.