Provider Demographics
NPI:1770980161
Name:FORD, JOANNA (LPC)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E SPEER BLVD STE 100B
Mailing Address - Street 2:#100B
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3724
Mailing Address - Country:US
Mailing Address - Phone:303-521-0731
Mailing Address - Fax:
Practice Address - Street 1:825 E SPEER BLVD STE 100B
Practice Address - Street 2:#100B
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3724
Practice Address - Country:US
Practice Address - Phone:303-521-0731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2016-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11836101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional