Thomas W Ford, PH.D.
Individual provider Active NPI Counseling Psychologist · La Fayette, GA
NPI 1457417792 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457417792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counseling Psychologist 103TC1900X
- License
- PSY002405 (GA)
- Practice address
- 501 Mize Street
La Fayette, GA 30728-1027 - Phone
- (706) 638-5584
- Fax
- (706) 638-5585
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY002405 | GA | MD | Counseling Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY002405 | GA | Yes |
Addresses
Primary practice location
501 Mize Street
La Fayette, GA 30728-1027
Mailing address
PO Box 1027
La Fayette, GA 30728-1027
Phone (706) 638-5584
Other providers in La Fayette, GA
- Family Care of Northwest Georgia
- Linda Farley
- Rebecca Finney
- Ford Chiropractic Inc.
- Thomas Aaron Ford
- Harold Neal Forence Jr.
- Margaret Shelton Forester
- Georgia CVS Pharmacy LLC
- Georgia Mountains Health Services, Inc.
- Shelby Gibson
All providers in La Fayette, GA · Counseling Psychologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.