Provider Demographics
NPI:1952337867
Name:FORD, NANCY VIRGINIA (MSW, MA)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:VIRGINIA
Last Name:FORD
Suffix:
Gender:F
Credentials:MSW, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 TIMBER LANE DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-3509
Mailing Address - Country:US
Mailing Address - Phone:810-733-6648
Mailing Address - Fax:
Practice Address - Street 1:5038 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1071
Practice Address - Country:US
Practice Address - Phone:810-720-5400
Practice Address - Fax:810-714-5494
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401004157101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional