MEDICARE: MS. KIM FORBES L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904003164	VA

General Provider Information

NPI Number	:	1689623522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIM FORBES L.C.S.W.

Provider Business Mailing Address
First Line	:	516 COLONIAL AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23507-2212
Country	:	US
Telephone Number	:	757-625-2063
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 COLUMBUS CTR STE 600
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6760
Country	:	US
Telephone Number	:	757-490-7860
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	03/22/2022

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