Provider Demographics
NPI:1356962807
Name:FORBES, FLEURETTE FOUGERE (LCSW-C)
Entity type:Individual
Prefix:
First Name:FLEURETTE
Middle Name:FOUGERE
Last Name:FORBES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 YORK RD APT 3123
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2873
Mailing Address - Country:US
Mailing Address - Phone:410-371-7275
Mailing Address - Fax:
Practice Address - Street 1:707 YORK RD APT 3123
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2873
Practice Address - Country:US
Practice Address - Phone:410-371-7275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD198311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty