Provider Demographics
NPI:1578551974
Name:WARD, JUDITH R (LPC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:R
Last Name:WARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37649 SNICKERSVILLE TPKE
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-5045
Mailing Address - Country:US
Mailing Address - Phone:540-338-6692
Mailing Address - Fax:
Practice Address - Street 1:37649 SNICKERSVILLE TPKE
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-5045
Practice Address - Country:US
Practice Address - Phone:540-338-6692
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001810101YP2500X
VA0717000867106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
092691OtherBLUE CROSS BLUE SHIELD
0001057135OtherMHN SERVICES