Provider Demographics
NPI:1073924718
Name:A - WARD COUNSELING
Entity Type:Organization
Organization Name:A - WARD COUNSELING
Other - Org Name:MARY CHRISTINE WARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:563-529-4515
Mailing Address - Street 1:56 DEER PATH CT
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:IL
Mailing Address - Zip Code:61254-9258
Mailing Address - Country:US
Mailing Address - Phone:563-529-4515
Mailing Address - Fax:
Practice Address - Street 1:56 DEER PATH CT
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:IL
Practice Address - Zip Code:61254-9258
Practice Address - Country:US
Practice Address - Phone:563-529-4515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty