Jennifer Leigh Forte, LCSW
Social Worker, Clinical in Ithaca, NY. Individual provider (NPI-1).
NPI number1114280625
StatusActive
Last updated in NPPESFeb 8, 2021
Details
- NPI
- 1114280625
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jennifer Leigh Forte
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 19, 2012
- Certification date
- Feb 8, 2021
- Last updated
- Feb 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 09065501 | NY | Yes |
| 174400000X | Specialist | 024772 | NY |
Practice location
201 E Green StIthaca, NY 14850-5635
Phone 516-474-2918
Mailing address
138 Bundy RdIthaca, NY 14850-9252
Phone 516-474-2918
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