Provider Demographics
NPI:1386844629
Name:FORSGREN, BRADLEY LUND (LMSW)
Entity type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:LUND
Last Name:FORSGREN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16333 HAFER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-4412
Mailing Address - Country:US
Mailing Address - Phone:281-537-0211
Mailing Address - Fax:281-537-0320
Practice Address - Street 1:16333 HAFER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-4412
Practice Address - Country:US
Practice Address - Phone:281-537-0211
Practice Address - Fax:281-537-0320
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1002411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical