Provider Demographics
NPI:1083711162
Name:WARD, HENSEL OWEN JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:HENSEL
Middle Name:OWEN
Last Name:WARD
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2242 OLYMPIC ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-2737
Mailing Address - Country:US
Mailing Address - Phone:937-390-7773
Mailing Address - Fax:937-390-8765
Practice Address - Street 1:2242 OLYMPIC ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2737
Practice Address - Country:US
Practice Address - Phone:937-390-7773
Practice Address - Fax:937-390-8765
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4444103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0824746Medicaid
OHR73152Medicare UPIN
OH0824746Medicaid