Provider Demographics
NPI:1730865304
Name:FORD, STACI CALHOUN (PHD)
Entity type:Individual
Prefix:DR
First Name:STACI
Middle Name:CALHOUN
Last Name:FORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:STACI
Other - Middle Name:CALHOUN
Other - Last Name:FLINT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:507 THOMAS ST REAR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-4650
Mailing Address - Country:US
Mailing Address - Phone:412-277-4616
Mailing Address - Fax:412-242-4147
Practice Address - Street 1:507 THOMAS ST REAR
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-4650
Practice Address - Country:US
Practice Address - Phone:412-277-4616
Practice Address - Fax:412-242-4147
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty