Provider Demographics
NPI:1235195603
Name:WARD, EUGENIA ANN (MA LLP LMSW)
Entity Type:Individual
Prefix:MS
First Name:EUGENIA
Middle Name:ANN
Last Name:WARD
Suffix:
Gender:F
Credentials:MA LLP LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 W BRECKENRIDGE
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220
Mailing Address - Country:US
Mailing Address - Phone:734-721-0200
Mailing Address - Fax:734-721-2008
Practice Address - Street 1:33101 ANNAPOLIS
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184
Practice Address - Country:US
Practice Address - Phone:313-961-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006676103T00000X
MI6801006676104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103T00000XBehavioral Health & Social Service ProvidersPsychologist