MEDICARE: KATHLEEN WARD, PHD, PC

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
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1679463319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHLEEN WARD, PHD, PC

Provider Business Mailing Address
First Line	:	609 S 2ND ST
Second Line	:
City	:	MCALESTER
State	:	OK
Zip	:	74501-5813
Country	:	US
Telephone Number	:	918-302-0203
Fax Number	:

Provider Business Practice Location Address
First Line	:	609 S 2ND ST
Second Line	:
City	:	MCALESTER
State	:	OK
Zip	:	74501-5813
Country	:	US
Telephone Number	:	918-302-0203
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	KATHLEEN A WARD
Credential	:	PH.D.
Telephone Number	:	918-302-0203

Provider Enumeration Date	:	07/04/2025
Last Update Date	:	07/04/2025

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