=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619142858
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BINAL P WARD PSY.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2008
-----------------------------------------------------
Last Update Date | 06/24/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1155 DRUMMOND LN
-----------------------------------------------------
City | STALLINGS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28104-8041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-576-9001
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2217 MATTHEWS TOWNSHIP PKWY STE D-249
-----------------------------------------------------
City | MATTHEWS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28105-4815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-825-3986
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------