Provider Demographics
NPI:1568926277
Name:WARD, MOLLY (LSW)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4803 E KENTUCKY AVE APT 615
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2224
Mailing Address - Country:US
Mailing Address - Phone:603-325-2127
Mailing Address - Fax:
Practice Address - Street 1:1780 S BELLAIRE ST STE 485
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4326
Practice Address - Country:US
Practice Address - Phone:603-325-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-27
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0009922004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional