Provider Demographics
NPI:1609443498
Name:WARD, WILLIAM (MSW, LCSW, LISW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:WARD
Suffix:
Gender:M
Credentials:MSW, LCSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 BENDELOW DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1380
Mailing Address - Country:US
Mailing Address - Phone:614-980-9328
Mailing Address - Fax:
Practice Address - Street 1:11 E CENTRAL AVE STE 103
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1944
Practice Address - Country:US
Practice Address - Phone:567-674-1886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0284481041C0700X
IDLMSW-44292104100000X
OHI.24061611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2910854Medicaid