Provider Demographics
NPI:1780030494
Name:FORTE, CORRIE MASSON
Entity Type:Individual
Prefix:
First Name:CORRIE
Middle Name:MASSON
Last Name:FORTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CORRIE
Other - Middle Name:LINN
Other - Last Name:MASSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:69 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-1910
Mailing Address - Country:US
Mailing Address - Phone:508-801-0635
Mailing Address - Fax:
Practice Address - Street 1:85 E NEWTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-414-8349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor