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NPI Code Detail

MEDICARE: CHARITYE FORD LCSW

MEDICARE: CHARITYE 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 Worker34011429AIN

General Provider Information

NPI Number : 1528886579
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARITYE FORD LCSW
Provider Business Mailing Address
First Line : 401 E 34TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-3754
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 401 E 34TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-3754
Country : US
Telephone Number : 317-926-1507
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2024
Last Update Date : 06/09/2026

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Directions to “ CHARITYE FORD LCSW” Practice Location

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