Provider Demographics
NPI:1407266323
Name:FORWARD COUNSELING, PLC
Entity Type:Organization
Organization Name:FORWARD COUNSELING, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:901-315-8625
Mailing Address - Street 1:560 COLONIAL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4097
Mailing Address - Country:US
Mailing Address - Phone:901-930-7397
Mailing Address - Fax:901-244-6548
Practice Address - Street 1:560 COLONIAL RD STE 2
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4019
Practice Address - Country:US
Practice Address - Phone:901-315-8625
Practice Address - Fax:901-244-6528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TNLSW00000056761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty