Provider Demographics
NPI:1588869796
Name:FORD, TARA STERLING (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:STERLING
Last Name:FORD
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:STERLING
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 MILFORD ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6966
Mailing Address - Country:US
Mailing Address - Phone:410-749-1015
Mailing Address - Fax:410-749-0654
Practice Address - Street 1:106 MILFORD ST STE 104
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6966
Practice Address - Country:US
Practice Address - Phone:410-543-8291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD151171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid
211862Medicare Oscar/Certification
MD119591300Medicaid