Healthcare Provider Details

I. General information

NPI: 1477469468
Provider Name (Legal Business Name): JACQUELINE RENEA WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 NORTHLAND BLVD STE 212
CINCINNATI OH
45246-3651
US

IV. Provider business mailing address

7864 GLENORCHARD DR # 2
CINCINNATI OH
45237-1045
US

V. Phone/Fax

Practice location:
  • Phone: 513-672-1640
  • Fax:
Mailing address:
  • Phone: 513-780-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: