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General NPI Number Information
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NPI Number | 1891201448
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Entity Type | Individual
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Provider Name | TRACIE JEANNE FORD LPCC
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Gender | Female
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 516 WASHINGTON ST STE E
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City | CHAGRIN FALLS
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State | OH
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Zip | 44022-4402
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Country | US
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Telephone | 216-219-0374
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Fax |
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Provider Business Mailing Address
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Address Line | 552 BLUEJAY TRL
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City | MACEDONIA
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State | OH
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Zip | 44056-2118
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.2505266
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C0800429
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License Number State | OH
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