Provider Demographics
NPI:1285044909
Name:WARD, CHERYL (LMSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 ASH ST
Mailing Address - Street 2:
Mailing Address - City:CARLETON
Mailing Address - State:MI
Mailing Address - Zip Code:48117-9737
Mailing Address - Country:US
Mailing Address - Phone:734-654-8588
Mailing Address - Fax:
Practice Address - Street 1:1106 ASH ST
Practice Address - Street 2:
Practice Address - City:CARLETON
Practice Address - State:MI
Practice Address - Zip Code:48117-9737
Practice Address - Country:US
Practice Address - Phone:734-654-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010336031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical