Provider Demographics
NPI:1902071400
Name:WARD, ELIZABETH (LCPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CMD DR
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:ME
Mailing Address - Zip Code:04910-6503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:60 FRONT ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6658
Practice Address - Country:US
Practice Address - Phone:508-904-1753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC3330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional