Provider Demographics
NPI:1710731500
Name:FORD, ALEXA (RMHCI)
Entity Type:Individual
Prefix:MS
First Name:ALEXA
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 PRESIDENT ST
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-6950
Mailing Address - Country:US
Mailing Address - Phone:340-344-5444
Mailing Address - Fax:
Practice Address - Street 1:3450 E LAKE RD STE 307
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2411
Practice Address - Country:US
Practice Address - Phone:727-238-5821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty