Individual
TRAVIS STEPHEN FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1345 PLANTATION RD NE, ROANOKE, VA 24012-5712
(833) 510-4357
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0904010949
VA
1041C0700X
Clinical Social Worker
0904010949
VA
Other
Enumeration date
06/09/2019
Last updated
11/13/2023
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