Provider Demographics
NPI:1861283913
Name:FORTE, MICHELE V (PHD LCSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:V
Last Name:FORTE
Suffix:
Gender:X
Credentials:PHD LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 THISTLE DR
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-6326
Mailing Address - Country:US
Mailing Address - Phone:518-796-0537
Mailing Address - Fax:
Practice Address - Street 1:22 THISTLE DR
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-6326
Practice Address - Country:US
Practice Address - Phone:518-796-0537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0940521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical