Provider Demographics
NPI:1346031010
Name:FORD, AALIYAH (LSW)
Entity type:Individual
Prefix:
First Name:AALIYAH
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 DEERFIELD RD APT 4
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-1350
Mailing Address - Country:US
Mailing Address - Phone:262-822-5642
Mailing Address - Fax:
Practice Address - Street 1:310 DEERFIELD RD APT 4
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-1350
Practice Address - Country:US
Practice Address - Phone:262-822-5642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.116050104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker