Provider Demographics
NPI:1841742210
Name:FORBES, CHENELLE ORAINNA (LCSWA)
Entity Type:Individual
Prefix:MS
First Name:CHENELLE
Middle Name:ORAINNA
Last Name:FORBES
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8909 215TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2405
Mailing Address - Country:US
Mailing Address - Phone:347-322-2584
Mailing Address - Fax:
Practice Address - Street 1:125 BROAD ST FL 18
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-2427
Practice Address - Country:US
Practice Address - Phone:212-385-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP011090104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1811571565Medicaid
NY1811571565OtherMEDICARE