Provider Demographics
NPI:1922075217
Name:FORBATH, MARGARITA M (LCSW-R)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:M
Last Name:FORBATH
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:MARGARITA
Other - Middle Name:D
Other - Last Name:MORGADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:686 KOELBEL CT
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3914
Mailing Address - Country:US
Mailing Address - Phone:516-546-0569
Mailing Address - Fax:516-546-9824
Practice Address - Street 1:686 KOELBEL CT
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-3914
Practice Address - Country:US
Practice Address - Phone:516-546-0569
Practice Address - Fax:516-546-9824
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-05
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR028688-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7352096OtherGHI PROVIDER NUMBER
NYP3106483OtherOXFORD PROVIDER ID NUMBER
NY000009404875OtherPHCS PROVIDER NUMBER
NY354762POtherHIP-HEALTH PLAN OF NY
NY9542ECOtherGHI MEDICARE PTAN
NYIP568045OtherMAGELLAN INDV PROVIDER NO
NYIPD284025000OtherINTEGRATED PROV DATABASE
2826093000OtherAMERIHEALTH PROVIDER ID
NY7197342OtherAETNA PROVIDER ID NO/PIN
A26820Other1199 SEIU BENEFIT FUND
NY556866OtherVALUE OPTIONS PROVIDER NO
11567232OtherCAQH PROVIDER ID
2826093000OtherAMERIHEALTH PROVIDER ID
NYIPD284025000OtherINTEGRATED PROV DATABASE