Provider Demographics
NPI:1104145580
Name:WARD, MALAIKA GHENET (LMSW)
Entity type:Individual
Prefix:MS
First Name:MALAIKA
Middle Name:GHENET
Last Name:WARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26130 W 12 MILE RD APT 217
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1779
Mailing Address - Country:US
Mailing Address - Phone:248-460-6529
Mailing Address - Fax:
Practice Address - Street 1:22720 WOODWARD AVE STE 105
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1752
Practice Address - Country:US
Practice Address - Phone:248-399-8032
Practice Address - Fax:248-399-8042
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801090166101YA0400X, 1041C0700X, 1041S0200X, 171M00000X, 251S00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health