Provider Demographics
NPI:1568847317
Name:FORD, LINDSEY DANIELLE (LMFT #116395)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:DANIELLE
Last Name:FORD
Suffix:
Gender:F
Credentials:LMFT #116395
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10147
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-0147
Mailing Address - Country:US
Mailing Address - Phone:707-319-6062
Mailing Address - Fax:
Practice Address - Street 1:649 CHAUCER LN
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-4237
Practice Address - Country:US
Practice Address - Phone:707-315-7473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116395106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist