Provider Demographics
NPI:1821105214
Name:FOREST, JOAN MCPHERSON (LICSW)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MCPHERSON
Last Name:FOREST
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 DREAMLAND LN
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-8108
Mailing Address - Country:US
Mailing Address - Phone:360-969-5583
Mailing Address - Fax:360-246-9218
Practice Address - Street 1:390 NE MIDWAY BLVD STE B206A
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-2642
Practice Address - Country:US
Practice Address - Phone:360-969-5583
Practice Address - Fax:360-246-9218
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000095601041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical