Provider Demographics
NPI:1609649151
Name:WARD, KRISTINA S (LMSW)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:S
Last Name:WARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 GREYSTONE AVE APT 61B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1956
Mailing Address - Country:US
Mailing Address - Phone:917-273-6554
Mailing Address - Fax:
Practice Address - Street 1:3900 GREYSTONE AVE APT 61B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1956
Practice Address - Country:US
Practice Address - Phone:917-273-6554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120966-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical