Provider Demographics
NPI:1225607377
Name:KAREN FORD, LICENSED COUNSELOR, LLC
Entity Type:Organization
Organization Name:KAREN FORD, LICENSED COUNSELOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LANDIS
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:617-610-5046
Mailing Address - Street 1:1400 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-5210
Mailing Address - Country:US
Mailing Address - Phone:617-610-5046
Mailing Address - Fax:
Practice Address - Street 1:35 BEDFORD ST STE 1
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4438
Practice Address - Country:US
Practice Address - Phone:617-610-5046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty