Healthcare Provider Details

I. General information

NPI: 1497881601
Provider Name (Legal Business Name): ANITA LYNNE WARD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MAIN ST
COLD SPRING NY
10516-2825
US

IV. Provider business mailing address

PO BOX 314
COLD SPRING NY
10516-0314
US

V. Phone/Fax

Practice location:
  • Phone: 917-597-6905
  • Fax:
Mailing address:
  • Phone: 917-597-6905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number075482
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: