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General NPI Number Information
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NPI Number | 1841110517
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Entity Type | Individual
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Provider Name | MR. LONNIE FORD JR.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 4358 RIVERSIDE DR. APPT.7419
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City | MACON
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State | GA
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Zip | 31210
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Country | US
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Telephone | 478-361-4946
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Fax |
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Provider Business Mailing Address
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Address Line | 4358 RIVERSIDE DR. APPT.7419
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City | MACON
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State | GA
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Zip | 31210
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Country | US
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Telephone | 478-361-4946
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1497
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License Number State | VA
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