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

Logan Michael Ballard

Individual provider Behavior Technician · NPI 1609613363

Logan Michael Ballard is a Behavior Technician in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2024.

Licensed in
AZ
In the registry since
2024

Practice location Address checks out

2355 W Lemarche Ave
Phoenix, AZ 85023-4122
Phone: (602) 688-6925
Fax: (602) 296-0414
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X · Licence RBT-24-357282 (AZ)

Record details

NPI number1609613363
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 10, 2024
Last updated in NPPESJuly 10, 2024
Certification dateJuly 2, 2024
Mailing address14191 W Calavar Rd, Surprise, AZ 85379-8623

Other providers in Phoenix