Healthcare Provider Details

I. General information

NPI: 1689598351
Provider Name (Legal Business Name): JODIE WARD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 VICTORS CT
RICHMOND HILL GA
31324-9431
US

IV. Provider business mailing address

269 VICTORS CT
RICHMOND HILL GA
31324-9431
US

V. Phone/Fax

Practice location:
  • Phone: 785-221-9452
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC016970
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: