Provider Demographics
NPI:1447374681
Name:FORD, KAREN (LMHC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-5210
Mailing Address - Country:US
Mailing Address - Phone:617-610-5046
Mailing Address - Fax:
Practice Address - Street 1:35 BEDFORD ST STE 1
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4438
Practice Address - Country:US
Practice Address - Phone:617-610-5046
Practice Address - Fax:781-861-6953
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALMG085OtherBCBS