Provider Demographics
NPI:1730553249
Name:WARD, CARLY MORRIS (MA, LPC)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:MORRIS
Last Name:WARD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7122 STONEWALL HL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-1926
Mailing Address - Country:US
Mailing Address - Phone:210-404-9696
Mailing Address - Fax:
Practice Address - Street 1:7122 STONEWALL HL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-1926
Practice Address - Country:US
Practice Address - Phone:210-404-9696
Practice Address - Fax:210-404-9466
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TX77836101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health