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NPI Code Detail

MEDICARE: SHAAKIRA A FORD LCSW

MEDICARE: SHAAKIRA A FORD LCSW
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
11041C0700XClinical Social WorkerCSW006444GA

General Provider Information

NPI Number : 1518457449
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAAKIRA A FORD LCSW
Provider Business Mailing Address
First Line : PO BOX 742616
Second Line :
City : ATLANTA
State : GA
Zip : 30374-2616
Country : US
Telephone Number : 770-219-8420
Fax Number :
Provider Business Practice Location Address
First Line : 4919 ATLANTA HWY
Second Line :
City : FLOWERY BRANCH
State : GA
Zip : 30542-3328
Country : US
Telephone Number : 770-848-9160
Fax Number : 770-848-9161
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2018
Last Update Date : 01/07/2021

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Directions to “ SHAAKIRA A FORD LCSW” Practice Location

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