Provider Demographics
NPI:1093526980
Name:FORSYTH, ALEC MARTIN (MHCA)
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:MARTIN
Last Name:FORSYTH
Suffix:
Gender:M
Credentials:MHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9806 28TH AVE SW # A303
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-4164
Mailing Address - Country:US
Mailing Address - Phone:253-765-8270
Mailing Address - Fax:
Practice Address - Street 1:9806 28TH AVE SW # A303
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-4164
Practice Address - Country:US
Practice Address - Phone:253-765-8270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YS0200X
WAMC61622237101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool