Provider Demographics
NPI:1629405683
Name:FORGASH, AARON RICHARD (MA LLPC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:RICHARD
Last Name:FORGASH
Suffix:
Gender:M
Credentials:MA LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9844 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:IRA
Mailing Address - State:MI
Mailing Address - Zip Code:48023-2813
Mailing Address - Country:US
Mailing Address - Phone:586-716-7600
Mailing Address - Fax:
Practice Address - Street 1:9844 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:IRA
Practice Address - State:MI
Practice Address - Zip Code:48023-2813
Practice Address - Country:US
Practice Address - Phone:586-716-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013925101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional