Provider Demographics
NPI:1871314757
Name:WARD, A'LEA RAE (LCSW)
Entity type:Individual
Prefix:
First Name:A'LEA
Middle Name:RAE
Last Name:WARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9203 ESTERO RIVER CIR
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-4418
Mailing Address - Country:US
Mailing Address - Phone:408-533-2618
Mailing Address - Fax:
Practice Address - Street 1:12670 NEW BRITTANY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3650
Practice Address - Country:US
Practice Address - Phone:239-326-2068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW237521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical