Healthcare Provider Details

I. General information

NPI: 1700905254
Provider Name (Legal Business Name): CAROL N WIARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3304 SW 34TH CIRCLE SUITE 202
OCALA FL
34474-3314
US

IV. Provider business mailing address

3304 SW 34TH CIRCLE SUITE 202
OCALA FL
34474-3314
US

V. Phone/Fax

Practice location:
  • Phone: 352-237-7712
  • Fax: 352-237-8363
Mailing address:
  • Phone: 352-237-7712
  • Fax: 352-237-8363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1342AD8149
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number590
License Number StateFL

VIII. Authorized Official

Name: MS. CAROL N WIARD
Title or Position: DIRECTOR
Credential: CAP
Phone: 352-237-7712