Provider Demographics
NPI:1629688296
Name:WARD, BENITA MAGDALENE (MS, LPC, LCDC)
Entity Type:Individual
Prefix:MRS
First Name:BENITA
Middle Name:MAGDALENE
Last Name:WARD
Suffix:
Gender:F
Credentials:MS, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5337 YORKTOWN BLVD STE 4A2
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-5361
Mailing Address - Country:US
Mailing Address - Phone:361-257-1845
Mailing Address - Fax:361-271-1287
Practice Address - Street 1:5337 YORKTOWN BLVD STE 4A2
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-5361
Practice Address - Country:US
Practice Address - Phone:361-257-1845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11508101YA0400X
TX82871101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)