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Individual

CELESTINE FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
1212 S 70TH ST STE 115A, MILWAUKEE, WI 53214-3105
(414) 902-1500
(414) 902-1515
Mailing address
1212 S 70TH ST STE 115A, MILWAUKEE, WI 53214-3105
(414) 902-1500
(414) 902-1515

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12717-131
WI
1041C0700X
Clinical Social Worker
Primary
3259-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12717-131
SAC
WI
01
3259-123
LCSW
WI
05
39591800
WI
Enumeration date
02/21/2008
Last updated
02/21/2008
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