Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 0003798 | OH |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | E0003798 | OH |
N | 101YP1600X | Pastoral Counselor | E0003798 | OH |
Y | 101YP2500X | Professional Counselor | EOOO3798 | OH |
NPI | 1134454671 |
---|---|
Provider Name | Mr. Stephen Wesley Ford |
First Address | Chillicothe, OH 45601-8167 |
Second Address | Reynoldsburg, OH 43068-8157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2009 |
Last Update Date | 11/06/2019 |