Provider Demographics
NPI:1952754889
Name:FORD, BRETT CAITLIN (PSYD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:CAITLIN
Last Name:FORD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CROSSINGS BLVD UNIT 1131
Mailing Address - Street 2:
Mailing Address - City:ELVERSON
Mailing Address - State:PA
Mailing Address - Zip Code:19520-9070
Mailing Address - Country:US
Mailing Address - Phone:619-274-0810
Mailing Address - Fax:
Practice Address - Street 1:223 BYERS RD
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425-9565
Practice Address - Country:US
Practice Address - Phone:619-274-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001504106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist