Provider Demographics
NPI:1629134119
Name:BADGER, DON WARD (LCSW)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:WARD
Last Name:BADGER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3912 LAKE POINT CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-8068
Mailing Address - Country:US
Mailing Address - Phone:919-787-7489
Mailing Address - Fax:919-787-7162
Practice Address - Street 1:3912 LAKE POINT CIR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-8068
Practice Address - Country:US
Practice Address - Phone:919-307-1643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0004211041C0700X
NC355106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist