Provider Demographics
NPI:1588713721
Name:WARD, CATHY LYNN (LPC)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:LYNN
Last Name:WARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25133
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-0433
Mailing Address - Country:US
Mailing Address - Phone:816-718-8006
Mailing Address - Fax:816-436-5522
Practice Address - Street 1:4401 NE VIVION RD
Practice Address - Street 2:SUITE 203
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-2807
Practice Address - Country:US
Practice Address - Phone:816-718-8006
Practice Address - Fax:816-436-5522
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional