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NPI Code Detail

MEDICARE: DR. JOSEPH ALLEN FORD LCSW

MEDICARE:  DR. JOSEPH ALLEN FORD  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904002422VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1195633OTHERILCOMPSYCH
211412343OTHERVACAQH
3088479OTHERVAANTHEM BC/BS

General Provider Information

NPI Number : 1619950235
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH ALLEN FORD LCSW
Provider Business Mailing Address
First Line : 1605 SWORD CT
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23464-8117
Country : US
Telephone Number : 757-479-2314
Fax Number : 757-622-8585
Provider Business Practice Location Address
First Line : 2412 E VIRGINIA BEACH BLVD
Second Line : SUITE D
City : NORFOLK
State : VA
Zip : 23504-3628
Country : US
Telephone Number : 757-622-7474
Fax Number : 757-622-8585
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 07/09/2007

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Directions to “ DR. JOSEPH ALLEN FORD LCSW” Practice Location

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