Provider Demographics
NPI:1467899476
Name:THERAPY WARD, LLC
Entity Type:Organization
Organization Name:THERAPY WARD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LADC
Authorized Official - Phone:860-889-6411
Mailing Address - Street 1:99 MAIN ST
Mailing Address - Street 2:3B
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-5732
Mailing Address - Country:US
Mailing Address - Phone:860-961-2274
Mailing Address - Fax:
Practice Address - Street 1:99 MAIN ST
Practice Address - Street 2:3B
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-5732
Practice Address - Country:US
Practice Address - Phone:860-961-2274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 1041C0700X
CT6597261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty