=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770244923
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXIA FORD LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2022
-----------------------------------------------------
Last Update Date | 12/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 140 WAGON TRL
-----------------------------------------------------
City | MANSFIELD
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30055-4422
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-371-6295
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 140 WAGON TRL
-----------------------------------------------------
City | MANSFIELD
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30055-4422
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-371-6295
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 10052
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CSW008843
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | SW23165
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------