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NPI Code Detail

MEDICARE: LYNNE FORD LICSW

MEDICARE: LYNNE FORD LICSW
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 Worker423NH

General Provider Information

NPI Number : 1629066311
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNNE FORD LICSW
Provider Business Mailing Address
First Line : PO BOX 2032
Second Line :
City : CONCORD
State : NH
Zip : 03302-2032
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 278 PLEASANT ST
Second Line :
City : CONCORD
State : NH
Zip : 03301-2551
Country : US
Telephone Number : 603-228-1551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 05/29/2014

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Directions to “ LYNNE FORD LICSW” Practice Location

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