Provider Demographics
NPI:1356877310
Name:WARD, BERNADETTE DENISE (LPC)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:DENISE
Last Name:WARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 BELAFONTE DR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-3706
Mailing Address - Country:US
Mailing Address - Phone:202-957-5536
Mailing Address - Fax:757-255-7139
Practice Address - Street 1:5268 GODWIN BLVD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8114
Practice Address - Country:US
Practice Address - Phone:757-255-7107
Practice Address - Fax:757-255-7139
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007127101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional