Healthcare Provider Details

I. General information

NPI: 1609379023
Provider Name (Legal Business Name): COURTNEY LONZETTA BONITA FORSETT MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2018
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 MAITLAND CENTER COMMONS BLVD STE 212
MAITLAND FL
32751-7270
US

IV. Provider business mailing address

1280 GRAND CAYMAN DR
MERRITT ISLAND FL
32952-7207
US

V. Phone/Fax

Practice location:
  • Phone: 321-745-9486
  • Fax:
Mailing address:
  • Phone: 321-459-9977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH16369
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH19630
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: