Provider Demographics
NPI:1235480252
Name:FORLEO, VINCENT (MS)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:FORLEO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3704
Mailing Address - Country:US
Mailing Address - Phone:401-903-0444
Mailing Address - Fax:401-661-8800
Practice Address - Street 1:211 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3704
Practice Address - Country:US
Practice Address - Phone:401-903-0444
Practice Address - Fax:401-661-8800
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGH57134Medicaid