Healthcare Provider Details

I. General information

NPI: 1669176814
Provider Name (Legal Business Name): ELISABETH LENEE FORTE MA, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7522 BIG BEND BLVD
SAINT LOUIS MO
63119-2104
US

IV. Provider business mailing address

12228 MIRIAM CT
NOBLESVILLE IN
46060-9436
US

V. Phone/Fax

Practice location:
  • Phone: 314-532-0544
  • Fax:
Mailing address:
  • Phone: 312-965-9126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number95000906A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2022038628
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: