| Doctor Name: | MR. RICHARD ERIC FORDE |
| NPI Number: | 1366444572 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | LPC003018 |
| Business Practice Address: | 3355 Old Jonesboro Rd Fairburn, GA - 302133233 |
| Business Phone Number: | 7709642138 |
| Business Fax Number: | 7709646135 |
| Mailing Address: | 3355 Old Jonesboro Rd, FAIRBURN |
| State: | GA |
| Postal Code: | 302133233 |
| Phone Number: | 7709642138 |
| Fax Number: | 7709646135 |
| NPI Enumeration Date: | 06/01/2005 |
| NPI Last Update Date: | 01/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC003018 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |