Provider Demographics
NPI:1922415603
Name:FORD, KAILI M (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KAILI
Middle Name:M
Last Name:FORD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 PLYMOUTH RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-3205
Mailing Address - Country:US
Mailing Address - Phone:734-997-5033
Mailing Address - Fax:248-620-6405
Practice Address - Street 1:3001 PLYMOUTH RD STE 105
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-3205
Practice Address - Country:US
Practice Address - Phone:734-997-5033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010967301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical