Provider Demographics
NPI:1366444572
Name:FORDE, RICHARD ERIC (LPC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ERIC
Last Name:FORDE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 CHESTER GARDEN LOOP
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1975
Mailing Address - Country:US
Mailing Address - Phone:770-780-6815
Mailing Address - Fax:
Practice Address - Street 1:4625 CHESTER GARDEN LOOP
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1975
Practice Address - Country:US
Practice Address - Phone:770-780-6815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013259101YP2500X
GALPC003018101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional