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General NPI Number Information
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NPI Number | 1801239660
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Entity Type | Individual
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Provider Name | JEANINE M FORSYTHE LPCC
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Gender | Female
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Dates
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Enumeration Date | 04/11/2013
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 3200 CARLISLE BLVD NE STE 225
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-1664
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Country | US
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Telephone | 505-453-7307
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Fax | 505-293-0617
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Provider Business Mailing Address
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Address Line | 7850 JEFFERSON ST NE STE 300
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4314
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Country | US
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Telephone | 505-884-1114
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Fax | 505-884-3004
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0113011
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License Number State | NM
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