Provider Demographics
NPI:1306967294
Name:FORREST, CATHERINE K (APRN)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:K
Last Name:FORREST
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WASHINGTON AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3271
Mailing Address - Country:US
Mailing Address - Phone:203-288-0414
Mailing Address - Fax:203-288-3655
Practice Address - Street 1:60 WASHINGTON AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3271
Practice Address - Country:US
Practice Address - Phone:203-288-0414
Practice Address - Fax:203-288-3655
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001954101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1306967294OtherNPI
CTMF0415679OtherDEA