Healthcare Provider Details

I. General information

NPI: 1164091310
Provider Name (Legal Business Name): ABBY FORD PLMHP, PLADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 9TH STREET
GERING NE
69341
US

IV. Provider business mailing address

2010 HIGHWAY 29
MITCHELL NE
69357
US

V. Phone/Fax

Practice location:
  • Phone: 308-225-4335
  • Fax: 308-633-2020
Mailing address:
  • Phone: 308-631-5389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberP-1874
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12595
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: