Provider Demographics
NPI:1316988603
Name:WARD, PATRICK JOSEPH (SS, LMFT,LMHC,SAP)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:WARD
Suffix:
Gender:M
Credentials:SS, LMFT,LMHC,SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E MAUD ST
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-3249
Mailing Address - Country:US
Mailing Address - Phone:352-253-9348
Mailing Address - Fax:352-253-9348
Practice Address - Street 1:101 E MAUD ST
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-3249
Practice Address - Country:US
Practice Address - Phone:352-253-9348
Practice Address - Fax:352-253-9348
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSAP101YA0400X
FLMH5422101YM0800X
FLMT1965101YP2500X
FLSS690101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ9971OtherBCBS