Provider Demographics
NPI:1356025746
Name:FORREST, JOCELYN A (BCBA, LABA)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:A
Last Name:FORREST
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PLEASANT ST APT 7-8
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-2375
Mailing Address - Country:US
Mailing Address - Phone:978-602-4436
Mailing Address - Fax:
Practice Address - Street 1:54 MIDDLESEX TPKE STE 103
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1411
Practice Address - Country:US
Practice Address - Phone:617-402-5444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4280-MH-B1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst