Provider Demographics
NPI:1518103639
Name:WARD, JOHN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:WARD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3731 KANAINA AVE
Mailing Address - Street 2:APT 338
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-4456
Mailing Address - Country:US
Mailing Address - Phone:510-967-1125
Mailing Address - Fax:
Practice Address - Street 1:3608 DIAMOND HEAD CIR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-4430
Practice Address - Country:US
Practice Address - Phone:510-967-1125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 57399106H00000X
HIMFT315106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist