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General NPI Number Information
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NPI Number | 1073924718
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Entity Type | Organization
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Legal Business Name | A - WARD COUNSELING
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Dates
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Enumeration Date | 05/15/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 56 DEER PATH CT
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City | GENESEO
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State | IL
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Zip | 61254-9258
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Country | US
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Telephone | 563-529-4515
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Fax |
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Provider Business Mailing Address
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Address Line | 56 DEER PATH CT
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City | GENESEO
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State | IL
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Zip | 61254-9258
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Country | US
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Telephone | 563-529-4515
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MRS. MARY CHRISTINE WARD
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Credential | L.C.P.C.
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Telephone | 563-529-4515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | IL
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