Healthcare Provider Details

I. General information

NPI: 1467387019
Provider Name (Legal Business Name): AMY FORD LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5602 BALTIMORE NATIONAL PIKE STE 204
CATONSVILLE MD
21228-1407
US

IV. Provider business mailing address

5602 BALTIMORE NATIONAL PIKE STE 204
CATONSVILLE MD
21228-1407
US

V. Phone/Fax

Practice location:
  • Phone: 717-954-5200
  • Fax:
Mailing address:
  • Phone: 717-954-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP17567
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: