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General NPI Number Information
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NPI Number | 1225607377
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Entity Type | Organization
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Legal Business Name | KAREN FORD, LICENSED COUNSELOR, LLC
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 35 BEDFORD ST STE 1
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City | LEXINGTON
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State | MA
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Zip | 02420-4438
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Country | US
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Telephone | 617-610-5046
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 LOWELL RD
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City | CONCORD
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State | MA
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Zip | 01742-5210
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Country | US
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Telephone | 617-610-5046
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | KAREN LANDIS FORD
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Credential | LMHC
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Telephone | 617-610-5046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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