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Contact Information

LUTISSUA D BALLARD, PSYD
210 W CONTINENTAL RD STE 229
GREEN VALLEY, AZ85622-3596
 Phone: 520-329-1579
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LUTISSUA D BALLARD · (Female)

NPI # 1093135659
Status Active
Credentials PSYD (Doctor of Psychology)
Entity Individual
Enumeration date 04/22/2014
Last updated 08/04/2025 - About 10 months ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # 4480
  • AZ Medicaid 914097
  • AZ Medicaid Z194557
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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