Provider Demographics
NPI:1790215044
Name:FORSYTHE, HENRY LEE JR (M ED)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:LEE
Last Name:FORSYTHE
Suffix:JR
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 E CARIBOU CT
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-5109
Mailing Address - Country:US
Mailing Address - Phone:225-362-4662
Mailing Address - Fax:
Practice Address - Street 1:4348 S JEFFREY DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4196
Practice Address - Country:US
Practice Address - Phone:225-361-0219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator