Provider Demographics
NPI:1437804929
Name:FORD, TYREE (LSW)
Entity Type:Individual
Prefix:
First Name:TYREE
Middle Name:
Last Name:FORD
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3818
Mailing Address - Country:US
Mailing Address - Phone:856-417-2087
Mailing Address - Fax:
Practice Address - Street 1:1910 JAMES ST
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3818
Practice Address - Country:US
Practice Address - Phone:856-417-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical