Provider Demographics
NPI:1235175092
Name:WARE, BILLY RAY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:RAY
Last Name:WARE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 E BULLARD AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5445
Mailing Address - Country:US
Mailing Address - Phone:559-438-1506
Mailing Address - Fax:559-447-9151
Practice Address - Street 1:728 E BULLARD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5445
Practice Address - Country:US
Practice Address - Phone:559-438-1506
Practice Address - Fax:559-447-9151
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS159631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical