Provider Demographics
NPI:1154677540
Name:WARD, LISA (MSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S SWOOPE AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5786
Mailing Address - Country:US
Mailing Address - Phone:407-622-0444
Mailing Address - Fax:
Practice Address - Street 1:225 S SWOOPE AVE STE 211
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5786
Practice Address - Country:US
Practice Address - Phone:407-622-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor