Provider Demographics
NPI:1275938607
Name:FORBES, MARCUS READ (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:READ
Last Name:FORBES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 ROCHESTER CT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-6471
Mailing Address - Country:US
Mailing Address - Phone:804-504-7200
Mailing Address - Fax:
Practice Address - Street 1:2300 ROCHESTER CT
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-6471
Practice Address - Country:US
Practice Address - Phone:804-269-7484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001856103T00000X
VA0812000642103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic