Provider Demographics
NPI:1184835381
Name:WARD, JARED
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:WARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 FERNBANK RD
Mailing Address - Street 2:
Mailing Address - City:STEENS
Mailing Address - State:MS
Mailing Address - Zip Code:39766-9306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:252 S VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-5022
Practice Address - Country:US
Practice Address - Phone:662-840-3008
Practice Address - Fax:662-841-0337
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor