Provider Demographics
NPI:1477135184
Name:FORBES, AMY LYNN (LCPC)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LYNN
Last Name:FORBES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:396 BELLE AIRE AVE
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-2010
Mailing Address - Country:US
Mailing Address - Phone:815-939-1912
Mailing Address - Fax:815-523-7428
Practice Address - Street 1:396 BELLE AIRE AVE
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2010
Practice Address - Country:US
Practice Address - Phone:815-939-1912
Practice Address - Fax:815-523-7428
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional