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NPI Code Detail

MEDICARE: MS. MARY LADD WARNER LCSW

MEDICARE:  MS. MARY LADD WARNER  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor1182CO
2104100000XSocial Worker#1182CO
31041C0700XClinical Social Worker1182CO

General Provider Information

NPI Number : 1023081106
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY LADD WARNER LCSW
Provider Business Mailing Address
First Line : 1206 1/2 N CASCADE AVE
Second Line : APARTMENT #6
City : COLORADO SPRINGS
State : CO
Zip : 80903-2362
Country : US
Telephone Number : 719-328-9301
Fax Number : 719-328-9301
Provider Business Practice Location Address
First Line : 1206 1/2 N CASCADE AVE
Second Line : APARTMENT #6
City : COLORADO SPRINGS
State : CO
Zip : 80903-2362
Country : US
Telephone Number : 719-328-9301
Fax Number : 719-328-9301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2006
Last Update Date : 05/04/2009

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Directions to “ MS. MARY LADD WARNER LCSW” Practice Location

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