Provider Demographics
NPI:1952675779
Name:FORTE, SOLANDY (PHD, LCSW, LBA)
Entity Type:Individual
Prefix:DR
First Name:SOLANDY
Middle Name:
Last Name:FORTE
Suffix:
Gender:F
Credentials:PHD, LCSW, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4631
Mailing Address - Country:US
Mailing Address - Phone:203-554-0763
Mailing Address - Fax:
Practice Address - Street 1:1 ENTERPRISE DR STE 110
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4631
Practice Address - Country:US
Practice Address - Phone:203-554-0763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2322103K00000X
CT0029103K00000X
CT0074241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
103K00000XOtherTAXONOMY