Provider Demographics
NPI:1679392088
Name:BALLARD, KATRINA (MA, MFT-C)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:BALLARD
Suffix:
Gender:F
Credentials:MA, MFT-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 QUITMAN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-1244
Mailing Address - Country:US
Mailing Address - Phone:720-333-7271
Mailing Address - Fax:
Practice Address - Street 1:4891 INDEPENDENCE ST STE 165
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6714
Practice Address - Country:US
Practice Address - Phone:303-456-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist