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NPI Code Detail

MEDICARE: SEAN FORBES LMSW, DP-C, CPRC

MEDICARE: SEAN FORBES LMSW, DP-C, CPRC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801121381MI
2175T00000XPeer Specialist

General Provider Information

NPI Number : 1720594260
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN FORBES LMSW, DP-C, CPRC
Provider Business Mailing Address
First Line : 3404 RIVERSIDE DR
Second Line :
City : PORT HURON
State : MI
Zip : 48060-1879
Country : US
Telephone Number : 810-858-9317
Fax Number :
Provider Business Practice Location Address
First Line : 3111 ELECTRIC AVE
Second Line :
City : PORT HURON
State : MI
Zip : 48060-8127
Country : US
Telephone Number : 810-985-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2017
Last Update Date : 04/01/2026

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