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General NPI Number Information
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NPI Number | 1912323650
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Entity Type | Individual
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Provider Name | LAURA JEANINE FORTE LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 13880 SHELBY TRL
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City | DELRAY BEACH
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State | FL
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Zip | 33484-1576
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Country | US
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Telephone | 917-995-1362
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Fax |
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Provider Business Mailing Address
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Address Line | 13880 SHELBY TRL
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City | DELRAY BEACH
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State | FL
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Zip | 33484-1576
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Country | US
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Telephone | 917-995-1362
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 072223
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License Number State | NY
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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 | R072223
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License Number State | NY
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