Healthcare Provider Details

I. General information

NPI: 1821458126
Provider Name (Legal Business Name): SADAQA WARD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2016
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 KENTUCKY ST STE 555
SCOTTDALE GA
30079-1124
US

IV. Provider business mailing address

610 KENTUCKY ST
SCOTTDALE GA
30079-1124
US

V. Phone/Fax

Practice location:
  • Phone: 213-423-3765
  • Fax:
Mailing address:
  • Phone: 213-423-3765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004266
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW004266
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: