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General NPI Number Information
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NPI Number | 1982743381
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Entity Type | Organization
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Legal Business Name | MARKITA FORD
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1801 N TRYON ST
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City | CHARLOTTE
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State | NC
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Zip | 28206-2704
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Country | US
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Telephone | 704-408-1882
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 EAST BLVD # 242
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City | CHARLOTTE
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State | NC
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Zip | 28203-5870
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Country | US
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Telephone | 704-408-1882
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MS. MARKITA ANTOINETTE FORD
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Credential | CSAC,LPC, NCC
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Telephone | 704-408-1882
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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 |
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License Number State |
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