Provider Demographics
NPI:1568716686
Name:FORD, ANGELA JEANNE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:JEANNE
Last Name:FORD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 CHURCH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4502
Mailing Address - Country:US
Mailing Address - Phone:603-344-1418
Mailing Address - Fax:
Practice Address - Street 1:54 CHURCH ST APT 1
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4502
Practice Address - Country:US
Practice Address - Phone:603-344-1418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH156106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist