MEDICARE: M. WARD COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114502309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M. WARD COUNSELING LLC

Provider Business Mailing Address
First Line	:	16479 ERSKINE ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68116-2585
Country	:	US
Telephone Number	:	531-466-5888
Fax Number	:	833-523-2433

Provider Business Practice Location Address
First Line	:	10846 OLD MILL RD STE 2
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-2652
Country	:	US
Telephone Number	:	531-466-5888
Fax Number	:	833-523-2433

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MARK EDWARD WARD
Credential	:	LIMHP
Telephone Number	:	531-466-5888

Provider Enumeration Date	:	03/10/2021
Last Update Date	:	02/11/2024

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