Healthcare Provider Details

I. General information

NPI: 1447281290
Provider Name (Legal Business Name): RICK MATTHEW FORD MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 COLLEGE AVE
ASHLAND OH
44805-3803
US

IV. Provider business mailing address

310 COLLEGE AVE
ASHLAND OH
44805-3803
US

V. Phone/Fax

Practice location:
  • Phone: 419-289-7675
  • Fax:
Mailing address:
  • Phone: 419-289-7675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberISW01447
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.0007429-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: