Provider Demographics
NPI:1386939692
Name:FORGETTE, YVONNE I (LSW)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:I
Last Name:FORGETTE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-5040
Mailing Address - Country:US
Mailing Address - Phone:978-283-7198
Mailing Address - Fax:978-281-7793
Practice Address - Street 1:33 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-5040
Practice Address - Country:US
Practice Address - Phone:978-283-7198
Practice Address - Fax:978-281-7793
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA313470104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker