Healthcare Provider Details

I. General information

NPI: 1063353076
Provider Name (Legal Business Name): THOMAS E FORD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 W MAIN ST
SYLVA NC
28779-7532
US

IV. Provider business mailing address

191 BERRY HILL DR
SYLVA NC
28779-6592
US

V. Phone/Fax

Practice location:
  • Phone: 828-226-5934
  • Fax:
Mailing address:
  • Phone: 828-226-5934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number20844A
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: