Dr Mirna E Ballestas, PSYD - Counselor in Chicago, IL

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Dr Mirna E Ballestas, PSYD is a Psychologist - Clinical based in Chicago, Illinois. Dr Mirna E Ballestas is licensed to practice in Illinois (license number 071.007650) and her current practice location is 4633 N Western Ave Ste 205, Chicago, Illinois. She can be reached at her office (for appointments etc.) via phone at (312) 476-9588.

NPI number for Dr Mirna E Ballestas is 1942427521 and her current mailing address is 5548 N Virginia Ave, Chicago, Illinois. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1942427521.

Contact Information

Dr Mirna E Ballestas, PSYD
4633 N Western Ave Ste 205,
Chicago, IL 60625-2087
(312) 476-9588
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameDr Mirna E Ballestas
GenderFemale
SpecialityPsychologist - Clinical
Location4633 N Western Ave Ste 205, Chicago, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1942427521
  • Provider Enumeration Date: 04/18/2007
  • Last Update Date: 08/25/2020

Medical Identifiers

Medical identifiers for Dr Mirna E Ballestas such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1942427521NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YM0800XCounselor - Mental Health 180-005584 (Illinois)Secondary
103TC0700XPsychologist - Clinical 071.007650 (Illinois)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mirna E Ballestas is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Mirna E Ballestas, PSYD
5548 N Virginia Ave,
Chicago, IL 60625-3918

Ph: (773) 610-8039		Dr Mirna E Ballestas, PSYD
4633 N Western Ave Ste 205,
Chicago, IL 60625-2087

Ph: (312) 476-9588

Reviews and Comments


Psychologist in Chicago, IL


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