Provider Demographics
NPI:1679355473
Name:ST FORT, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:ST FORT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 NW 2ND TER
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-5019
Mailing Address - Country:US
Mailing Address - Phone:175-423-5800
Mailing Address - Fax:
Practice Address - Street 1:CULTIVATE BEHAVIORAL HEALTH AND EDUCATION
Practice Address - Street 2:9970 S. CENTRAL PARK BOULEVARD. SUITE 401.
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428
Practice Address - Country:US
Practice Address - Phone:305-807-1909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst