Provider Demographics
NPI:1790823854
Name:WARD, SUSAN KAY (MA, MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:KAY
Last Name:WARD
Suffix:
Gender:F
Credentials:MA, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9255 TOWNE CENTRE DR
Mailing Address - Street 2:STE.370
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3033
Mailing Address - Country:US
Mailing Address - Phone:858-450-3210
Mailing Address - Fax:858-458-9767
Practice Address - Street 1:9255 TOWNE CENTRE DR
Practice Address - Street 2:STE.370
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3033
Practice Address - Country:US
Practice Address - Phone:858-450-3210
Practice Address - Fax:858-458-9767
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 13789101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health