Jeffrey Dale Ford, SUDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO61319735 Issued in WA

Practice address

4301 W Sunset Blvd
Spokane, WA 99224-5157

Phone

(509) 953-6674

NPI assigned

Dec 27, 2022

Last updated

Dec 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1942913603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E NORTH FOOTHILLS DR APT B102",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992072716",
            "telephone_number": "509-953-5768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W SUNSET BLVD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992245157",
            "telephone_number": "509-953-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "JEFFREY",
        "middle_name": "DALE",
        "credential": "SUDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61319735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeff.ford@cceasternwa.org",
            "affiliation": "N",
            "endpointDescription": "laptop",
            "address_1": "4301 W Sunset Blvd",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992245157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aaron Ford
• Brittany Ford, LMP
• Jackie Lee Ford, CDP
• Jarred Erl Ford, LMFT INTERN
• Jayme Ford
• Joshua Cole Ford
• McKenzie L Ford, OTR/L
• Patrice Marie Ford
• Jennifer Forim, SLP
• Form Speech and Swallowing PLLC

• Addiction (Substance Use Disorder) Counselor in Spokane, WA
• Providers in Spokane, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.