Provider Demographics
NPI:1780747642
Name:WARD, LAURA E (LCSW-R)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:WARD
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9578 ROUTE 434
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850
Mailing Address - Country:US
Mailing Address - Phone:607-341-0624
Mailing Address - Fax:607-729-7779
Practice Address - Street 1:9578 NYS ROUTE 434
Practice Address - Street 2:EVA CARE
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850
Practice Address - Country:US
Practice Address - Phone:607-341-0624
Practice Address - Fax:607-729-7779
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0766461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical