Provider Demographics
NPI:1144385055
Name:FORD, MARCIA ANNE (LCSW, NCAC I)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:ANNE
Last Name:FORD
Suffix:
Gender:F
Credentials:LCSW, NCAC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 W JEWELL AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-7187
Mailing Address - Country:US
Mailing Address - Phone:303-935-9750
Mailing Address - Fax:
Practice Address - Street 1:6565 W JEWELL AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-7187
Practice Address - Country:US
Practice Address - Phone:303-935-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9897131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical