Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derique Ballard

Individual provider Mental Health Counselor · NPI 1649890997

Derique Ballard is a Mental Health Counselor in Westampton, New Jersey. Registered with an NPI since 2020.

In the registry since
2020
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Practice location Address checks out

770 Woodlane Rd
Westampton, NJ 08060-3804
Phone: (609) 267-5928
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1649890997
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 16, 2020
Last updated in NPPESApril 16, 2020
Certification dateApril 16, 2020
Mailing address770 Woodlane Rd, Westampton, NJ 08060-3804

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