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General NPI Number Information
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NPI Number | 1093982092
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Entity Type | Individual
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Provider Name | DAVID LIONEL FORSTADT PSYD, LPC, CASAC
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Gender | Male
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 805 E BROWARD BLVD STE 301
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2046
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Country | US
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Telephone | 323-205-5345
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Fax |
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Provider Business Mailing Address
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Address Line | 544 NE 14TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-1275
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Country | US
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Telephone | 716-908-3066
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 25987
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC.0016363
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC.9293
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH.18797
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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