Provider Demographics
NPI:1144989732
Name:WARD, CHANDRE (LCSW)
Entity type:Individual
Prefix:
First Name:CHANDRE
Middle Name:
Last Name:WARD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21311 AVETT DR
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-3485
Mailing Address - Country:US
Mailing Address - Phone:713-419-8865
Mailing Address - Fax:
Practice Address - Street 1:21311 AVETT DR
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-3485
Practice Address - Country:US
Practice Address - Phone:713-419-8865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-11
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX615461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical