Provider Demographics
NPI:1972988228
Name:FORTES, DEIDRE (LMHC)
Entity type:Individual
Prefix:
First Name:DEIDRE
Middle Name:
Last Name:FORTES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:DEIDRE
Other - Middle Name:
Other - Last Name:FARMER/PRESCOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:62 READ ST
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-4610
Mailing Address - Country:US
Mailing Address - Phone:401-952-7850
Mailing Address - Fax:508-639-5298
Practice Address - Street 1:1240 PAWTUCKET AVE
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:RI
Practice Address - Zip Code:02916-1427
Practice Address - Country:US
Practice Address - Phone:401-952-7850
Practice Address - Fax:508-639-5298
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health