Ward, Clay Herold
Ward, Clay Herold is an sole proprietor health care provider with primary practice located at 3061 S Meridian Rd Suite 150, Meridian ID 83642-7962. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Ward, Clay Herold can be contacted via phone (208) 631-5063.Contact Information
Primary practice address
3061 S Meridian Rd Suite 150
Meridian ID 83642-7962
Phone: (208) 631-5063
Fax: (208) 887-0950
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | PSY239 | Idaho |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY239 | Idaho |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY-239 | Idaho |
Profile Details
| NPI number | 1053348441 |
|---|---|
| LBN Legal business name | Ward, Clay Herold |
| Credentials | PH.D. CLINICAL PSYCH |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Nov 13th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053348441 | NPPES |
| Idaho | Other | 00001001591 | REGENCE BLUE SHIELD |
| Idaho | Other | 1598959322 | REGENCE BLUE SHIELD |
| Idaho | Other | N2399 | REGENCE BLUE SHIELD |
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