MEDICARE: MRS. HEATHER LYNN WARD LPC

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	LPC7204	ID
2	101YP2500X	Professional Counselor		AK
3	101YM0800X	Mental Health Counselor	A16503	NC
4	101YP2500X	Professional Counselor	177718	AK

General Provider Information

NPI Number	:	1952075392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER LYNN WARD LPC

Provider Business Mailing Address
First Line	:	64 BIRCH HILL DR
Second Line	:
City	:	JBER
State	:	AK
Zip	:	99505-1009
Country	:	US
Telephone Number	:	907-854-9361
Fax Number	:

Provider Business Practice Location Address
First Line	:	1450 MULDOON RD STE 111
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-2873
Country	:	US
Telephone Number	:	907-762-8668
Fax Number	:	907-375-3177

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

Provider Enumeration Date	:	08/08/2021
Last Update Date	:	08/08/2021

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