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

Maya Simone White Ballou, LCAS-A

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1699633271

Maya Simone White Ballou, LCAS-A is an Addiction (Substance Use Disorder) Counselor in Charlotte, North Carolina. Practices as a sole proprietor. Licensed in North Carolina.

Licensed in
NC
In the registry since
2026

Practice location Address checks out

6636 E W T Harris Blvd
Charlotte, NC 28215-5133
Phone: (704) 553-5392
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence LCAS-30724 (NC)

Record details

NPI number1699633271
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCAS-A
Sole proprietorYes
NPI enumeratedJanuary 13, 2026
Last updated in NPPESJanuary 13, 2026
Certification dateJanuary 13, 2026

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