Provider Demographics
NPI:1568975951
Name:WARD, NADIA LYNDORA (PHD)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:LYNDORA
Last Name:WARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MEADOW VIEW RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-4452
Mailing Address - Country:US
Mailing Address - Phone:203-907-7522
Mailing Address - Fax:
Practice Address - Street 1:389 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2301
Practice Address - Country:US
Practice Address - Phone:203-789-7645
Practice Address - Fax:203-562-6355
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003258103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist