Provider Demographics
NPI:1164151486
Name:WARD, CARLY ROSE (LMHC)
Entity type:Individual
Prefix:MS
First Name:CARLY
Middle Name:ROSE
Last Name:WARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6D CANDLELIGHT CT
Mailing Address - Street 2:
Mailing Address - City:HALFMOON
Mailing Address - State:NY
Mailing Address - Zip Code:12065-4150
Mailing Address - Country:US
Mailing Address - Phone:631-786-1008
Mailing Address - Fax:
Practice Address - Street 1:1068 HUDSON AVE RM 204B
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:NY
Practice Address - Zip Code:12170-3432
Practice Address - Country:US
Practice Address - Phone:518-292-5433
Practice Address - Fax:518-899-4930
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY016879101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health