Provider Demographics
NPI:1477571750
Name:WARD, SHARON JUANITA (LMHC, CDP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:JUANITA
Last Name:WARD
Suffix:
Gender:F
Credentials:LMHC, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7902 SAPPHIRE DR SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-5037
Mailing Address - Country:US
Mailing Address - Phone:253-966-0651
Mailing Address - Fax:253-967-1411
Practice Address - Street 1:BAXTER CONSULTANTS LLC
Practice Address - Street 2:10209 BRIDGEPORT WAY SW SUITE A5
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499
Practice Address - Country:US
Practice Address - Phone:253-221-8895
Practice Address - Fax:253-302-5989
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR05-11-68101YA0400X
WALH00011031101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1477571750Medicaid