Healthcare Provider Details

I. General information

NPI: 1093967226
Provider Name (Legal Business Name): ASHLEY FORTE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 01/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2621 VICTORY PKWY
CINCINNATI OH
45206-1754
US

IV. Provider business mailing address

1201 S FORT THOMAS AVE
FORT THOMAS KY
41075-2421
US

V. Phone/Fax

Practice location:
  • Phone: 513-684-7968
  • Fax:
Mailing address:
  • Phone: 859-781-5596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.0800690
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: