Individual
KEVIN FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
740 MARNE HWY STE 108, MOORESTOWN, NJ 08057-3126
(732) 644-3008
Mailing address
24 EAST LN, LEVITTOWN, PA 19054-2702
(732) 644-3008
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00194600
NJ
101YM0800X
Mental Health Counselor
37PC00881700
NJ
101YP2500X
Professional Counselor
Primary
37PC00881700
NJ
Other
Enumeration date
10/23/2014
Last updated
09/08/2022
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