Provider Demographics
NPI:1992992036
Name:FORBES, DOROTHY ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ANNE
Last Name:FORBES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:ANNE
Other - Last Name:SACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:616 FERNANDEZ RD
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6531
Mailing Address - Country:US
Mailing Address - Phone:575-779-6786
Mailing Address - Fax:
Practice Address - Street 1:217 PASEO DEL PUEBLO NORTE STE E
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-5963
Practice Address - Country:US
Practice Address - Phone:575-825-3522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-086371041C0700X
NMC-086371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical