Provider Demographics
NPI:1124291398
Name:WARD, JESSICA N (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:N
Last Name:WARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MOUNT PLEASANT RD
Mailing Address - Street 2:NEWTOWN YOUTH AND FAMILY SERVICES, INC.
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1537
Mailing Address - Country:US
Mailing Address - Phone:203-426-8103
Mailing Address - Fax:203-426-0550
Practice Address - Street 1:121 MOUNT PLEASANT RD
Practice Address - Street 2:NEWTOWN YOUTH AND FAMILY SERVICES, INC.
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1537
Practice Address - Country:US
Practice Address - Phone:203-426-8103
Practice Address - Fax:203-426-0550
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT 0050311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTANC1319OtherOXFORD GROUP CLINIC
CT004125862-GROUPMedicaid
CT77ABH0020CT01OtherANTHEM GROUP CLINIC