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NPI Code Detail

MEDICARE: SONYA FORD CASE MANAGER

MEDICARE: SONYA FORD CASE MANAGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor187051OH

General Provider Information

NPI Number : 1275389793
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONYA FORD CASE MANAGER
Provider Business Mailing Address
First Line : 9400 ADAMS AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44108-3223
Country : US
Telephone Number : 216-402-1773
Fax Number :
Provider Business Practice Location Address
First Line : 1400 E 55TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-1304
Country : US
Telephone Number : 216-391-6672
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2024
Last Update Date : 04/25/2024

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