Darrell Demetrius Ford

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A16820 Issued in NC

Practice address

312 W Millbrook Rd Ste 129
Raleigh, NC 27609-4398

Phone

(919) 877-6101

Fax

(919) 876-4953

NPI assigned

Aug 2, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A New Life Services Inc

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1679882393
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1043984297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 MEMORY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283045828",
            "telephone_number": "910-797-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W MILLBROOK RD STE 129",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094398",
            "telephone_number": "919-877-6101",
            "fax_number": "919-876-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "DARRELL",
        "middle_name": "DEMETRIUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A16820",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A16820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Forcinito, RD
• Deirdre Ford-Frazier
• Annie Ford-Hollingsworth, PHD
• Sherri Lynn Ford-Jacobs, LPCA
• Angela Kaye Ford, LCAS-A
• Emily B Ford, RD, LDN
• Jane Zolecki Ford, M.H.S., P.T.
• Lauren Kimberly Ford, PT, DPT
• Monique La Vette Ford, RN
• Nanette Catherine Ford, LCMHCA, LCAS

• Professional Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.