Healthcare Provider Details

I. General information

NPI: 1982153235
Provider Name (Legal Business Name): CALLI FORD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CALLI J. HANKINS

II. Dates (important events)

Enumeration Date: 09/28/2016
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E POLSTON AVE
POST FALLS ID
83854-9049
US

IV. Provider business mailing address

109 N WABASH ST
HOBART IN
46342-4031
US

V. Phone/Fax

Practice location:
  • Phone: 208-618-0787
  • Fax: 208-625-5641
Mailing address:
  • Phone: 219-203-0814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34010817A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: