| Doctor Name: | DR. KELLY WARD |
| NPI Number: | 1295876332 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD, MSW, LCSW, LCAD |
| License Number: | 2008R |
| Business Practice Address: | 400 Cedar Ave Department Of Social Work West Long Branch, NJ - 077641804 |
| Business Phone Number: | 7325713515 |
| Business Fax Number: | 7322635217 |
| Mailing Address: | 400 Cedar Ave, Department Of Social Work WEST LONG BRANCH |
| State: | NJ |
| Postal Code: | 077641804 |
| Phone Number: | 7325713515 |
| Fax Number: | 7322635217 |
| NPI Enumeration Date: | 02/10/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 2008R |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |