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Individual
MS. THERESA FLANAGAN FORDHAM
Active
Individual
MS. THERESA FLANAGAN FORDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC LSW
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0934
MS
104100000X
Social Worker
W4171
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
472900000
MAGELLAN HEALTH
MS
01
—
A931421
VALUE OPTIONS
MS
Enumeration date
10/03/2006
Last updated
01/19/2017
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