MEDICARE: AUDREY WARD LCSW

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	1041C0700X	Clinical Social Worker	C7991	MS

General Provider Information

NPI Number	:	1578968848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY WARD LCSW

Provider Business Mailing Address
First Line	:	270 SCRUGGS RD
Second Line	:
City	:	SUMRALL
State	:	MS
Zip	:	39482-3915
Country	:	US
Telephone Number	:	601-408-4331
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 PROFESSIONAL PKWY STE 101
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-2648
Country	:	US
Telephone Number	:	601-408-4331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2014
Last Update Date	:	08/04/2025

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