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Contact Information

AMY D FORD, LSCSW
1601 W 4TH ST
COFFEYVILLE, KS67337-3333
 Phone: 620-252-8180
 Fax: 620-332-1940
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for AMY D FORD · (Female)

NPI # 1205871613
Status Active
Credentials LSCSW
Entity Individual
Enumeration date 06/19/2006
Last updated 03/27/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • KS License # 348
  • KS License # LSCSW 3833
  • KS Medicaid 200435870A
  • KS Other 6919003 MEDICARE PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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