MEDICARE: MS. APRIL LYNN FORELLA MS, MH9797

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
1	101YM0800X	Mental Health Counselor	MH9797	FL

General Provider Information

NPI Number	:	1942454020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. APRIL LYNN FORELLA MS, MH9797

Provider Business Mailing Address
First Line	:	3307 NORTHLAKE BLVD
Second Line	:	SUITE B104
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1703
Country	:	US
Telephone Number	:	561-818-6964
Fax Number	:

Provider Business Practice Location Address
First Line	:	3307 NORTHLAKE BLVD
Second Line	:	SUITE B104
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1703
Country	:	US
Telephone Number	:	561-818-6964
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2008
Last Update Date	:	05/29/2013

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