Active NPI
Reva McMillan Ford, LCSW
- Clinical Social Worker
- Dallas, TX
National Provider Identifier
1649924754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 59988
- Practice address
- 15190 Prestonwood Blvd Apt 3131023
Dallas, TX 75248-4730 - Phone
- (318) 381-9554
- NPI assigned
- Feb 8, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 59988 | TX | Primary |
Addresses
Primary practice location
15190 Prestonwood Blvd Apt 3131023
Dallas, TX 75248-4730
Mailing address
PO Box 801206
Dallas, TX 75380-1206
Phone (318) 381-9554
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59988 | Other | TX | TBSWE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | MONROE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- revamcmillanford@tdh.allscriptsdirect.net
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644278400000",
"number": "1649924754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 801206",
"city": "DALLAS",
"state": "TX",
"postal_code": "753801206",
"telephone_number": "318-381-9554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15190 PRESTONWOOD BLVD APT 3131023",
"city": "DALLAS",
"state": "TX",
"postal_code": "752484730",
"telephone_number": "318-381-9554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMILLAN FORD",
"first_name": "REVA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-08",
"last_updated": "2022-02-08",
"certification_date": "2022-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "59988",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TBSWE",
"identifier": "59988",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "MONROE",
"affiliation": "N",
"address_1": "15190 Prestonwood Blvd Apt 3131023",
"city": "Dallas",
"state": "TX",
"country_code": "US",
"postal_code": "752484730",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.