Provider Demographics
NPI:1114990801
Name:WARE, DAVID E (MSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:WARE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 W HOLMES RD 143
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-0435
Mailing Address - Country:US
Mailing Address - Phone:517-667-0061
Mailing Address - Fax:517-507-4888
Practice Address - Street 1:913 W HOLMES RD
Practice Address - Street 2:SUITE 222
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-0426
Practice Address - Country:US
Practice Address - Phone:517-393-5830
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-11
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN68010179951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical