Provider Demographics
NPI:1669763850
Name:FORSTER, PEGGY-SUE K (LMFT)
Entity type:Individual
Prefix:MRS
First Name:PEGGY-SUE
Middle Name:K
Last Name:FORSTER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 POST RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06890-1217
Mailing Address - Country:US
Mailing Address - Phone:203-984-1126
Mailing Address - Fax:
Practice Address - Street 1:2551 POST RD
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:CT
Practice Address - Zip Code:06890-1217
Practice Address - Country:US
Practice Address - Phone:203-984-1126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001441106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist