Provider Demographics
NPI:1295594919
Name:CATHERINE FORD COUNSELING PLLC
Entity type:Organization
Organization Name:CATHERINE FORD COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, LCASA
Authorized Official - Phone:919-920-4415
Mailing Address - Street 1:317 E TREMONT AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-6291
Mailing Address - Country:US
Mailing Address - Phone:919-920-4415
Mailing Address - Fax:
Practice Address - Street 1:3719 LATROBE DR STE 830
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-5120
Practice Address - Country:US
Practice Address - Phone:704-993-6808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty