Provider Demographics
NPI:1144531989
Name:BARBARA FORSTBERG LCSW LLC
Entity type:Organization
Organization Name:BARBARA FORSTBERG LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORSTBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-742-3040
Mailing Address - Street 1:21 BREAD AND MILK ST
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:CT
Mailing Address - Zip Code:06238-1012
Mailing Address - Country:US
Mailing Address - Phone:860-742-3040
Mailing Address - Fax:
Practice Address - Street 1:21 BREAD AND MILK ST
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:CT
Practice Address - Zip Code:06238-1012
Practice Address - Country:US
Practice Address - Phone:860-742-3040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-26
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health