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NPI Code Detail

MEDICARE: NICOLE FORD LICSW

MEDICARE: NICOLE 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 WorkerISW01727RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
105025885813OTHERPACIFICARE
212398751OTHERMULTIPLAN
3829691000OTHERMAGELLAN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
531134-0OTHERBLUE CROSS-BLUE SHIELD
6413185OTHERBLUE CHIP
71021740OTHERNHP GROUP NUMBER

General Provider Information

NPI Number : 1912049347
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE FORD LICSW
Provider Business Mailing Address
First Line : 73 GOULD ST
Second Line :
City : WAKEFIELD
State : RI
Zip : 02879-2903
Country : US
Telephone Number : 401-331-1350
Fax Number : 401-277-3366
Provider Business Practice Location Address
First Line : 650 TEN ROD RD UNIT 13
Second Line : FAMILY SERVICE OF RHODE ISLAND
City : NORTH KINGSTOWN
State : RI
Zip : 02852-4237
Country : US
Telephone Number : 401-331-1350
Fax Number : 401-277-3366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

Similar Medicare Providers

1689682429 — LORNA H. THOMPSON LICSW
Practice Location Address:
650 TEN ROD RD UNIT 13 , C/O FAMILY SERVICE OF RHODE ISLAND
N KINGSTOWN, RI
02852-4237
Practice Phone: 401-331-1350
Practice Fax: 401-277-3366
1194883215 — LINDA CLOUTIER LMFT
Practice Location Address:
650 TEN ROD RD UNIT 13 , FAMILY SERIVCE OF RHODE ISLAND
NORTH KINGSTOWN, RI
02852-4237
Practice Phone: 401-331-1350
Practice Fax: 401-277-3366
1083779276 — DURINDA CHACE LICSW
Practice Location Address:
650 TEN ROD RD UNIT 13 , FAMILY SERVICE OF RHODE ISLAND
NORTH KINGSTOWN, RI
02852-4237
Practice Phone: 401-331-1350
Practice Fax: 401-277-3366
1427190859 — HEATHER BLAZEJEWSKI RN
Practice Location Address:
650 TEN ROD RD UNIT 13 , FAMILY SERVICE OF RHODE ISLAND, INC
NORTH KINGSTOWN, RI
02852-4237
Practice Phone: 401-331-1350
Practice Fax: 401-277-3366
1821237124 — DEBRA STRAUSS-LEVINE LICSW
Practice Location Address:
650 TEN ROD RD UNIT 13 , C/O FSRI
NORTH KINGSTOWN, RI
02852-4237
Practice Phone: 401-331-1350
Practice Fax: 401-277-3366
1962630046 — KAREN E KERSHAW LMFT
Practice Location Address:
650 TEN ROD RD UNIT 13 , C/O FAMILY SERVICE OF RHODE ISLAND, INC
NORTH KINGSTOWN, RI
02852-4237
Practice Phone: 401-331-1350
Practice Fax: 401-277-3366

Directions to “ NICOLE FORD LICSW” Practice Location

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