1669183661 NPI number — J. ASHLEY WARD, LICENSED PROFESSIONAL COUNSELOR, PLLC

Table of content: (NPI 1669183661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669183661 NPI number — J. ASHLEY WARD, LICENSED PROFESSIONAL COUNSELOR, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
J. ASHLEY WARD, LICENSED PROFESSIONAL COUNSELOR, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669183661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2244 SAINT PAUL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80910-3208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-757-8494
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
620 S CASCADE AVE STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80903-4051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-757-8494
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/09/2022

Additional Information

Authorized Official

Authorized Official Last Name:
WARD
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
ASHLEY
Authorized Official Title or Position:
CLINICAL THERAPIST
Authorized Official Telephone Number:
719-757-8494

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 14766 . This is a "LPC - LICENSED PROFESSIONAL COUNSELOR" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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