Healthcare Provider Details

I. General information

NPI: 1316075294
Provider Name (Legal Business Name): PERCY FORD JR. MC,LPC-MHSP,NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2472 OLD FORT PKWY
MURFREESBORO TN
37128-4163
US

IV. Provider business mailing address

4183 FRANKLIN ROAD, STE B1 BOX 153
MURFREESBORO TN
37128
US

V. Phone/Fax

Practice location:
  • Phone: 615-692-4935
  • Fax: 855-261-6356
Mailing address:
  • Phone: 615-692-4935
  • Fax: 855-261-6356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC04889
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number068.0136584TELE
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCP6091-R
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number39005641A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC8059
License Number StateME
# 6
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2643
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC10966
License Number StateOR
# 9
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberTPMC5074
License Number StateFL
# 10
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLMHC1006116
License Number StateMA
# 11
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC05675
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: