Provider Demographics
NPI:1184157059
Name:LAFOREST, ABBIE LIN (LLMSW)
Entity type:Individual
Prefix:MS
First Name:ABBIE
Middle Name:LIN
Last Name:LAFOREST
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:LIN
Other - Last Name:MELDRUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26030 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3773
Mailing Address - Country:US
Mailing Address - Phone:586-738-0398
Mailing Address - Fax:
Practice Address - Street 1:26030 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-3773
Practice Address - Country:US
Practice Address - Phone:586-738-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-07
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011006911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical