Provider Demographics
NPI:1811354582
Name:WARD, ALLEN J (LCSW)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:J
Last Name:WARD
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2991 HILLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14057-1250
Mailing Address - Country:US
Mailing Address - Phone:716-680-2320
Mailing Address - Fax:
Practice Address - Street 1:987 R C HOAG DR
Practice Address - Street 2:
Practice Address - City:SALAMANCA
Practice Address - State:NY
Practice Address - Zip Code:14779-1365
Practice Address - Country:US
Practice Address - Phone:716-945-5894
Practice Address - Fax:716-242-6345
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0805251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10382932OtherIHA
NY170110000071OtherFIDELIS
NY000537918001OtherBCBS
NY04800322Medicaid