Provider Demographics
NPI:1336395813
Name:FORD & FORD COUNSELING AND CONSULTING, PLLC
Entity Type:Organization
Organization Name:FORD & FORD COUNSELING AND CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-525-5850
Mailing Address - Street 1:9223 FOUR ACRE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-7974
Mailing Address - Country:US
Mailing Address - Phone:704-525-5850
Mailing Address - Fax:
Practice Address - Street 1:9223 FOUR ACRE CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-7974
Practice Address - Country:US
Practice Address - Phone:704-525-5850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006533Medicaid