Provider Demographics
NPI:1528778966
Name:FORBES, RANDEL M JR (MA)
Entity type:Individual
Prefix:MR
First Name:RANDEL
Middle Name:M
Last Name:FORBES
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 W SNYDER ST
Mailing Address - Street 2:
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870-1504
Mailing Address - Country:US
Mailing Address - Phone:570-809-4235
Mailing Address - Fax:
Practice Address - Street 1:8 W SNYDER ST STE 2
Practice Address - Street 2:
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-1504
Practice Address - Country:US
Practice Address - Phone:570-809-4235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health