Provider Demographics
NPI:1407317605
Name:FORBES, ERROL RICARDO (RMHCI)
Entity Type:Individual
Prefix:MR
First Name:ERROL
Middle Name:RICARDO
Last Name:FORBES
Suffix:
Gender:M
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4193 NW 54TH ST
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4001
Mailing Address - Country:US
Mailing Address - Phone:954-830-9047
Mailing Address - Fax:
Practice Address - Street 1:4193 NW 54TH ST
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4001
Practice Address - Country:US
Practice Address - Phone:954-830-9047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH14463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIMH14463OtherMENTAL HEALTH COUNSELING INT