Provider Demographics
NPI:1639832983
Name:WARD, BRIAN ADAM (LMSW-CC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:ADAM
Last Name:WARD
Suffix:
Gender:M
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 POLAND RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-4263
Mailing Address - Country:US
Mailing Address - Phone:207-344-6226
Mailing Address - Fax:
Practice Address - Street 1:227 POLAND RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-4263
Practice Address - Country:US
Practice Address - Phone:207-344-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC185671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical