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General NPI Number Information
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NPI Number | 1093214348
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Entity Type | Individual
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Provider Name | JIMMY WARD MS, MDIV
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Gender | Male
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | 35109 ROYAL PL
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City | SOLDOTNA
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State | AK
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Zip | 99669-9755
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Country | US
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Telephone | 907-741-2725
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Fax | 907-260-7427
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Provider Business Mailing Address
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Address Line | PO BOX 1185
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City | KASILOF
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State | AK
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Zip | 99610-1185
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Country | US
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Telephone | 907-741-2725
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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