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General NPI Number Information
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NPI Number | 1164151486
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Entity Type | Individual
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Provider Name | CARLY ROSE WARD LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 1068 HUDSON AVE RM 204B
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City | STILLWATER
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State | NY
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Zip | 12170-3432
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Country | US
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Telephone | 518-292-5433
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Fax | 518-899-4930
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Provider Business Mailing Address
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Address Line | 6D CANDLELIGHT CT
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City | HALFMOON
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State | NY
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Zip | 12065-4150
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Country | US
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Telephone | 631-786-1008
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 016879
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License Number State | NY
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