Provider Demographics
NPI:1801219969
Name:JAMES PATRICK WARD
Entity Type:Organization
Organization Name:JAMES PATRICK WARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLGY
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,LPC
Authorized Official - Phone:304-865-0274
Mailing Address - Street 1:3705 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-1118
Mailing Address - Country:US
Mailing Address - Phone:304-865-0272
Mailing Address - Fax:304-865-0265
Practice Address - Street 1:3705 EMERSON AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1118
Practice Address - Country:US
Practice Address - Phone:304-865-0272
Practice Address - Fax:304-865-0265
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMES PATRICK WARD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-27
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1723101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHF143OtherSTATE LICENSE
WV1723OtherSTATE LICENSE