Active NPI
Earnest Ford, LPC
- Mental Health Counselor
- Gilbert, AZ
National Provider Identifier
1679779607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC-13204
- Practice address
- 115 W Sagebrush St
Gilbert, AZ 85233-6916 - Phone
- (602) 448-5970
- NPI assigned
- Jun 26, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-13204 | AZ | Primary |
Addresses
Primary practice location
115 W Sagebrush St
Gilbert, AZ 85233-6916
Mailing address
2152 South Vineyard
BLDG. 4 Ste. 109-1
Mesa, AZ 85201-5661
Phone (480) 507-3340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPC-13204 | Other | AZ | LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-13204 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252627200000",
"number": "1679779607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2152 SOUTH VINEYARD",
"address_2": "BLDG. 4 STE. 109-1",
"city": "MESA",
"state": "AZ",
"postal_code": "852015661",
"telephone_number": "480-507-3340",
"fax_number": "480-507-3317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W SAGEBRUSH ST",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852336916",
"telephone_number": "602-448-5970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "EARNEST",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-26",
"last_updated": "2009-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LPC-13204",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "LPC-13204",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.