Provider Demographics
NPI:1518338144
Name:FORTE, SHAYLYN M (LPC)
Entity type:Individual
Prefix:
First Name:SHAYLYN
Middle Name:M
Last Name:FORTE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 E HAZZARD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-1306
Mailing Address - Country:US
Mailing Address - Phone:484-416-0826
Mailing Address - Fax:484-421-3693
Practice Address - Street 1:2305 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-2515
Practice Address - Country:US
Practice Address - Phone:484-416-0826
Practice Address - Fax:484-421-3693
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor