Provider Demographics
NPI:1891034278
Name:FORD, ANDREA J (MS, LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:J
Last Name:FORD
Suffix:
Gender:F
Credentials:MS, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-2305
Mailing Address - Country:US
Mailing Address - Phone:214-296-7965
Mailing Address - Fax:
Practice Address - Street 1:415 N ELM ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-2305
Practice Address - Country:US
Practice Address - Phone:214-296-7965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health