Provider Demographics
NPI:1750926028
Name:FORWARD PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:FORWARD PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE DIRECTOR/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:PAIG
Authorized Official - Last Name:SAGALOW
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC, NCC
Authorized Official - Phone:610-716-8290
Mailing Address - Street 1:226 W RITTENHOUSE SQ APT 2113
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5752
Mailing Address - Country:US
Mailing Address - Phone:610-716-8290
Mailing Address - Fax:
Practice Address - Street 1:100 S BROAD ST STE 920
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19110-1016
Practice Address - Country:US
Practice Address - Phone:610-716-8290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)