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General NPI Number Information
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NPI Number | 1811491145
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Entity Type | Individual
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Provider Name | BREANNA M WARD LSCSW
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Gender | Female
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 1978 E 4TH ST
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City | PITTSBURG
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State | KS
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Zip | 66762-9100
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Country | US
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Telephone | 620-670-3896
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1832
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City | PITTSBURG
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State | KS
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Zip | 66762-1832
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Country | US
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Telephone | 620-231-9873
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 05445
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 161409
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License Number State | PR
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