Provider Demographics
NPI:1649588799
Name:ERIC WARD, LPC
Entity Type:Organization
Organization Name:ERIC WARD, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:469-744-5765
Mailing Address - Street 1:2523 CLAY MATHIS RD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-1811
Mailing Address - Country:US
Mailing Address - Phone:469-744-5765
Mailing Address - Fax:972-222-3288
Practice Address - Street 1:2523 CLAY MATHIS RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-1811
Practice Address - Country:US
Practice Address - Phone:469-744-5765
Practice Address - Fax:972-222-3288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62855251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health