Provider Demographics
NPI:1700494630
Name:WARD, GENEVIEVE S (NCC, LMHC)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:S
Last Name:WARD
Suffix:
Gender:F
Credentials:NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 MAPLE AVE SW STE 240
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3100
Mailing Address - Country:US
Mailing Address - Phone:425-610-6162
Mailing Address - Fax:
Practice Address - Street 1:1123 MAPLE AVE SW STE 240
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-3100
Practice Address - Country:US
Practice Address - Phone:425-610-6162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-16
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61021041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health