Provider Demographics
NPI:1295216471
Name:FORSGARD, CHRISTINE NOEL (MSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:NOEL
Last Name:FORSGARD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DEER COMMON DR
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-2154
Mailing Address - Country:US
Mailing Address - Phone:781-724-8559
Mailing Address - Fax:
Practice Address - Street 1:20 DEER COMMON DR
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-2154
Practice Address - Country:US
Practice Address - Phone:781-724-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104100000X
MA1027231-SW-LICSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker