Provider Demographics
NPI:1083913289
Name:WARD, JOAN COLLEEN (LPCC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:COLLEEN
Last Name:WARD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65064 250TH AVE
Mailing Address - Street 2:
Mailing Address - City:KASSON
Mailing Address - State:MN
Mailing Address - Zip Code:55944-1195
Mailing Address - Country:US
Mailing Address - Phone:507-251-6768
Mailing Address - Fax:
Practice Address - Street 1:65064 250TH AVE
Practice Address - Street 2:
Practice Address - City:KASSON
Practice Address - State:MN
Practice Address - Zip Code:55944-1195
Practice Address - Country:US
Practice Address - Phone:507-251-6768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00295101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health