Provider Demographics
NPI:1447581012
Name:WARD, MARY C (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:C
Last Name:WARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
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Mailing Address - Street 1:20412 W 874 RD
Mailing Address - Street 2:
Mailing Address - City:PARK HILL
Mailing Address - State:OK
Mailing Address - Zip Code:74451-2970
Mailing Address - Country:US
Mailing Address - Phone:918-822-0653
Mailing Address - Fax:918-686-8881
Practice Address - Street 1:111 1/2 S YORK ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-5952
Practice Address - Country:US
Practice Address - Phone:918-682-7797
Practice Address - Fax:918-686-8881
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health