Provider Demographics
NPI:1114502309
Name:M. WARD COUNSELING LLC
Entity Type:Organization
Organization Name:M. WARD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP
Authorized Official - Phone:531-466-5888
Mailing Address - Street 1:16479 ERSKINE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2585
Mailing Address - Country:US
Mailing Address - Phone:531-466-5888
Mailing Address - Fax:833-523-2433
Practice Address - Street 1:10846 OLD MILL RD STE 2
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2652
Practice Address - Country:US
Practice Address - Phone:531-466-5888
Practice Address - Fax:833-523-2433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026865401Medicaid
NE10026865400Medicaid