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General NPI Number Information
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NPI Number | 1609856152
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Entity Type | Individual
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Provider Name | LAURIE JANE FORBES LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 16499 NE 19TH AVE
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-4105
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Country | US
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Telephone | 305-576-3266
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 NE 192ND ST APT 1610
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City | AVENTURA
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State | FL
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Zip | 33180-2458
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Country | US
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Telephone | 305-794-6685
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Fax | 305-705-3388
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT0000339
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW0000732
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License Number State | FL
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