Healthcare Provider Details

I. General information

NPI: 1447707732
Provider Name (Legal Business Name): DANIELLE FORTE LICSW, PMH-C, CPD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2016
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1785 COLUMBUS AVE
ROXBURY MA
02119-1041
US

IV. Provider business mailing address

1785 COLUMBUS AVE
ROXBURY MA
02119-1041
US

V. Phone/Fax

Practice location:
  • Phone: 508-954-6651
  • Fax:
Mailing address:
  • Phone: 508-954-6651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW122810
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: