Provider Demographics
NPI:1023042439
Name:WARD, CAROL ANN (LPC,NCC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:WARD
Suffix:
Gender:F
Credentials:LPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-0418
Mailing Address - Country:US
Mailing Address - Phone:608-752-7255
Mailing Address - Fax:608-752-6942
Practice Address - Street 1:1519 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-0418
Practice Address - Country:US
Practice Address - Phone:608-752-7255
Practice Address - Fax:608-752-6942
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI772-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39218400Medicaid