Provider Demographics
NPI:1760623425
Name:FORSTBERG, BARBARA (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:FORSTBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7002 BUTTONBUSH LOOP
Mailing Address - Street 2:
Mailing Address - City:HARMONY
Mailing Address - State:FL
Mailing Address - Zip Code:34773-6001
Mailing Address - Country:US
Mailing Address - Phone:407-891-9499
Mailing Address - Fax:
Practice Address - Street 1:1101 W HIBISCUS BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2719
Practice Address - Country:US
Practice Address - Phone:321-914-0564
Practice Address - Fax:860-986-6151
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0061741041C0700X
FLSW145121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical