Edwin Allen Ford, LMSW
Individual provider Active NPI Clinical Social Worker · Carson City, MI
NPI 1033201231 · NPPES record last updated Jan 25, 2023
Key facts
- NPI
- 1033201231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801059502 (MI)
- Practice address
- 406 E Elm St
Carson City, MI 48811-9693 - Phone
- (989) 584-3131
- Fax
- (989) 584-1221
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050511000232 | MI | Practitioner - Clinical Social Worker | 9638119480 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Hope Christian Counseling & Mental Health Center | Clinical | Current |
Accepting new patients |
Locations
6728 Vining Rd
Greenville, MI 48838
Phone (616) 225-8220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801059502 | MI | |
| Clinical Social Worker | 1041C0700X | 6801059502 | MI | Yes |
Addresses
Primary practice location
406 E Elm St
Carson City, MI 48811-9693
Mailing address
6375 Snow Ave SE
Alto, MI 49302-9750
Phone (269) 953-6769
Other practice location 1
6728 Vining Rd
Greenville, MI 48838-9784
Phone (616) 225-8220
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1715928 | Medicaid | MI |
Other providers in Carson City, MI
- Edward W. Sparrow Hospital Association
- Lisa L Ferguson
- Seth Thomas Ferguson
- Five CS Communication Care PLC
- Foot & Ankle Specialists of West Michigan P L L C
- Fresh Horizons Counseling LLC
- Audrey Lee Garnsey
- James H Gilkins Jr.
- Krystal Gillhespy
- Grandview Foot and Ankle PC
All providers in Carson City, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.