Provider Demographics
NPI:1104914928
Name:FORD, NANCY L (LPCC)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:L
Last Name:FORD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5936 GLENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2009
Mailing Address - Country:US
Mailing Address - Phone:513-922-1660
Mailing Address - Fax:513-922-6230
Practice Address - Street 1:5936 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2009
Practice Address - Country:US
Practice Address - Phone:513-922-1660
Practice Address - Fax:513-922-6230
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0000210101YP2500X
KYKY 0272101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCI9282111Medicare ID - Type Unspecified