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General NPI Number Information
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NPI Number | 1427373406
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Entity Type | Organization
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Legal Business Name | DONALD FORD COUNSELING, LLC
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Dates
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Enumeration Date | 04/01/2010
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Last Update Date | 04/01/2010
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Provider Practice Location Address
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Address Line | 10490 SW EASTRIDGE ST
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City | PORTLAND
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State | OR
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Zip | 97225-5030
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Country | US
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Telephone | 503-297-2413
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Fax |
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Provider Business Mailing Address
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Address Line | 10490 S.W. EASTRIDGE ST.,
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City | PORTLAND
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State | OR
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Zip | 97225
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Country | US
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Telephone | 503-297-2413
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. DONALD FORD
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Credential | M.A., LPC, LMFT
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Telephone | 503-297-2413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | TO246
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CO402
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License Number State | OR
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