Provider Demographics
NPI:1992552699
Name:TERENCE FORD MARRIAGE AND FAMILY THERAPY INC
Entity type:Organization
Organization Name:TERENCE FORD MARRIAGE AND FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-923-1127
Mailing Address - Street 1:633 W 5TH ST FL 26
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90071-2053
Mailing Address - Country:US
Mailing Address - Phone:310-923-1127
Mailing Address - Fax:
Practice Address - Street 1:633 W 5TH ST FL 26
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90071-2053
Practice Address - Country:US
Practice Address - Phone:310-923-1127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty