Provider Demographics
NPI:1497427868
Name:WARD, JOHN WILLIS (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIS
Last Name:WARD
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5002 LAKELAND CIR STE B
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-2900
Mailing Address - Country:US
Mailing Address - Phone:254-401-5781
Mailing Address - Fax:254-822-6162
Practice Address - Street 1:5002 LAKELAND CIR STE B
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-2900
Practice Address - Country:US
Practice Address - Phone:254-401-5781
Practice Address - Fax:254-822-6162
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-04
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX625471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical