Provider Demographics
NPI:1669723037
Name:WARD, R. ERIC (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:R.
Middle Name:ERIC
Last Name:WARD
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 S GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-4053
Mailing Address - Country:US
Mailing Address - Phone:828-403-6817
Mailing Address - Fax:
Practice Address - Street 1:188 S GARDEN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-4053
Practice Address - Country:US
Practice Address - Phone:828-403-6817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5358101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor