Individual provider · Type 1 NPI
Maya Simone White Ballou, LCAS-A
Addiction (Substance Use Disorder) Counselor · Charlotte, NC
NPI number
1699633271
Active
Practice location
6636 E W T Harris Blvd
Charlotte, NC 28215-5133
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | LCAS-30724 (NC) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
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About NPI 1699633271
Maya Simone White Ballou, LCAS-A's National Provider Identifier is 1699633271, issued on Jan 13, 2026. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Charlotte, NC. The record was last updated on Jan 13, 2026.