MEDICARE: ABIGAIL ENID WARD MA, LPCC, NCC

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	LPCC.0015427	CO

General Provider Information

NPI Number	:	1821594771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL ENID WARD MA, LPCC, NCC

Provider Business Mailing Address
First Line	:	8315 SASSAFRAS DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-5778
Country	:	US
Telephone Number	:	719-200-3083
Fax Number	:

Provider Business Practice Location Address
First Line	:	3210 E WOODMEN RD STE 110
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3591
Country	:	US
Telephone Number	:	719-445-6744
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2018
Last Update Date	:	03/31/2018

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