Provider Demographics
NPI:1164420865
Name:DIEHL, FORREST E (LPCC)
Entity Type:Individual
Prefix:MR
First Name:FORREST
Middle Name:E
Last Name:DIEHL
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-0607
Mailing Address - Country:US
Mailing Address - Phone:440-992-7565
Mailing Address - Fax:440-257-7997
Practice Address - Street 1:1907 AETNA RD
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-6259
Practice Address - Country:US
Practice Address - Phone:440-992-7565
Practice Address - Fax:440-257-7997
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1439101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor