Dr Lutissua D Ballard, PSYD is a medicare enrolled "Psychologist - Clinical Child & Adolescent" provider in Green Valley, Arizona. Her current practice location is
210 W Continental Rd Ste 229, Green Valley, Arizona. You can reach out to her office (for appointments etc.) via phone at
(520) 329-1579.
Dr Lutissua D Ballard is licensed to practice in Arizona (license number 4480) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1093135659.
Healthcare Provider's Profile
Full Name | Dr Lutissua D Ballard |
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Gender | Female |
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Speciality | Psychologist - Clinical Child & Adolescent |
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Location | 210 W Continental Rd Ste 229, Green Valley, Arizona |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1093135659
- Provider Enumeration Date: 04/22/2014
- Last Update Date: 03/04/2024
Medicare PECOS Information:
- PECOS PAC ID: 2860770195
- Enrollment ID: I20161020001878
Medical Identifiers
Medical identifiers for Dr Lutissua D Ballard such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1093135659 | NPI | - | NPPES |
914097 | Medicaid | AZ | |
Z194557 | Medicaid | AZ | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC2200X | Psychologist - Clinical Child & Adolescent | 4480 (Arizona) | 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 Lutissua D Ballard is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Lutissua D Ballard, PSYD Po Box 204, Fort Mill, SC 29716-0204 Ph: (520) 329-1579 | Dr Lutissua D Ballard, PSYD 210 W Continental Rd Ste 229, Green Valley, AZ 85622-3596 Ph: (520) 329-1579 |
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