Provider Demographics
NPI:1184656589
Name:WARD, TERESA M (MA LMHP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:M
Last Name:WARD
Suffix:
Gender:F
Credentials:MA LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N BAILEY AVE
Mailing Address - Street 2:PO BOX 1209
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-5436
Mailing Address - Country:US
Mailing Address - Phone:308-534-6029
Mailing Address - Fax:308-534-6961
Practice Address - Street 1:110 N BAILEY AVE
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5436
Practice Address - Country:US
Practice Address - Phone:308-534-6029
Practice Address - Fax:308-534-6961
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
84668OtherBCBS