Provider Demographics
NPI:1720965817
Name:WARD, ROBERTA CORINNE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:CORINNE
Last Name:WARD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3101 OCEAN PARK BLVD STE 311
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-3022
Mailing Address - Country:US
Mailing Address - Phone:310-383-6137
Mailing Address - Fax:
Practice Address - Street 1:3101 OCEAN PARK BLVD STE 311
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3022
Practice Address - Country:US
Practice Address - Phone:310-383-6137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA164261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical