Provider Demographics
NPI:1811584840
Name:FORD, ROBIN KING (LPC - S)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:KING
Last Name:FORD
Suffix:
Gender:F
Credentials:LPC - S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 REIDHURST AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1618
Mailing Address - Country:US
Mailing Address - Phone:662-210-0369
Mailing Address - Fax:
Practice Address - Street 1:4599 COUNTY ROAD 660
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75442-5612
Practice Address - Country:US
Practice Address - Phone:903-217-7152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42999101YA0400X
TX77344101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)