Provider Demographics
NPI:1568133189
Name:T. C. FORD CONSULTING, LLC
Entity Type:Organization
Organization Name:T. C. FORD CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:D
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-718-4503
Mailing Address - Street 1:PO BOX 1861
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-0061
Mailing Address - Country:US
Mailing Address - Phone:314-718-4503
Mailing Address - Fax:618-416-2708
Practice Address - Street 1:2608 GREYSTONE ESTATES PKWY
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62221-3513
Practice Address - Country:US
Practice Address - Phone:618-978-7343
Practice Address - Fax:618-416-2708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149.018180OtherIL DEPT. OF FINANCIAL AND PROFESSIONAL REGULATION
MO2016002322OtherMO DEPT . OF PROFESSIONAL REGISTRATION