Provider Demographics
NPI:1992804314
Name:WARD, JAMES PARKER (LCSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PARKER
Last Name:WARD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4212
Mailing Address - Country:US
Mailing Address - Phone:847-421-4900
Mailing Address - Fax:847-948-8681
Practice Address - Street 1:464 CENTRAL AVENUE
Practice Address - Street 2:SUITE 30
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3040
Practice Address - Country:US
Practice Address - Phone:847-421-4900
Practice Address - Fax:847-948-8681
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001633784OtherBCBS