Provider Demographics
NPI:1609019967
Name:FORRESTER, JAMES ERNEST (EDD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ERNEST
Last Name:FORRESTER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 CORPORATION LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3162
Mailing Address - Country:US
Mailing Address - Phone:757-552-7179
Mailing Address - Fax:757-552-7508
Practice Address - Street 1:4417 CORPORATION LN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3162
Practice Address - Country:US
Practice Address - Phone:757-552-7179
Practice Address - Fax:757-552-7508
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000588101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701000588OtherBOARD OF COUNSELING