Provider Demographics
NPI:1962169110
Name:WARD, CARMELIA RYIEL (LCSWA)
Entity type:Individual
Prefix:
First Name:CARMELIA
Middle Name:RYIEL
Last Name:WARD
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3282 WELLONS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5234
Mailing Address - Country:US
Mailing Address - Phone:252-571-1100
Mailing Address - Fax:252-351-0322
Practice Address - Street 1:3282 WELLONS BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5234
Practice Address - Country:US
Practice Address - Phone:252-571-1100
Practice Address - Fax:252-351-0322
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2022-09-20
Deactivation Date:2022-08-05
Deactivation Code:
Reactivation Date:2022-09-15
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NCRBT-22-200489106S00000X
NCP0180721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician