Provider Demographics
NPI:1235640087
Name:WARD GROUP, LLC
Entity Type:Organization
Organization Name:WARD GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:910-977-3712
Mailing Address - Street 1:4801 KENMORE AVE APT 1112
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1118
Mailing Address - Country:US
Mailing Address - Phone:910-977-3712
Mailing Address - Fax:703-997-4872
Practice Address - Street 1:8440 OLD KEENE MILL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-2302
Practice Address - Country:US
Practice Address - Phone:910-977-3712
Practice Address - Fax:703-997-4872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007216101YP2500X
NC8734101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty