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General NPI Number Information
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NPI Number | 1962593111
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Entity Type | Organization
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Legal Business Name | LAKELAND PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1141 A GREENWOOD LAKE TURNPIKE
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City | RINGWOOD
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State | NJ
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Zip | 07456
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Country | US
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Telephone | 973-728-7474
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Fax |
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Provider Business Mailing Address
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Address Line | 349 LAKEVIEW AVENUE
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City | RINGWOOD
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State | NJ
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Zip | 07456-2118
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Country | US
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Telephone | 973-962-4293
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROSARIA M. WARD M. WARD
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Credential | PH.D.
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Telephone | 973-962-4293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35SI00211100
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License Number State | NJ
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