Provider Demographics
NPI:1790058766
Name:FORREST, BARRY LEE (LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:LEE
Last Name:FORREST
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2422
Mailing Address - Country:US
Mailing Address - Phone:301-897-2500
Mailing Address - Fax:
Practice Address - Street 1:10500 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2422
Practice Address - Country:US
Practice Address - Phone:301-897-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical