Provider Demographics
NPI:1215149919
Name:FORTE, KAREN (LCSW, DCSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:FORTE
Suffix:
Gender:F
Credentials:LCSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6356
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-6356
Mailing Address - Country:US
Mailing Address - Phone:541-388-0095
Mailing Address - Fax:
Practice Address - Street 1:360 NE KEARNEY AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4550
Practice Address - Country:US
Practice Address - Phone:541-388-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical