Jack L. Fortenberry in Choctaw - Counselor
Jack L. Fortenberry - NPI 1023155645
Jack L. Fortenberry is a Counselor in Choctaw, Oklahoma. Jack L. Fortenberry practices all healthcare services and medical treatments related to Counselor. The NPI Number for Jack L. Fortenberry is 1023155645. The last update date is 2007-07-08.
Jack L. Fortenberry's current location address is Po Box 695, Choctaw, Oklahoma. You can contact this provider via phone number 4053908131 and fax number 4053908134. The mailing address for Jack L. Fortenberry is Po Box 695, Choctaw, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack L. Fortenberry |
|---|---|
| Address | Po Box 695, Choctaw, Oklahoma |
| Phone Number | 4053908131 |
| Fax Number | 4053908134 |
| Sole Proprietor | N |
| Credentials | LMSW |
NPI Number Detail
| NPI Number | 1023155645 |
|---|---|
| Provider Enumeration Date | 2007-01-31 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | Po Box 695 |
|---|---|
| City | Choctaw |
| State | Oklahoma (OK) |
| Post Code | 730200695 |
| Phone Number | 4053908131 |
| Fax Number | 4053908134 |
Provider's Primary Taxonomy Detail
| Speciality | Counselor |
|---|---|
| Taxonomy | 101Y00000X |
| Licence No | 3030 |
|
Definition: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supe |
|
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Jack L. Fortenberry by the Centers for Medicare & Medicaid Services?
The Jack L. Fortenberry has been issued the NPI (National Provider Identifier) 1023155645, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Jack L. Fortenberry?
The Jack L. Fortenberry is situated at Po Box 695, in the city of Choctaw, state of OK, with the zip code 730200695.
What is the Jack L. Fortenberry's area of specialization and corresponding taxonomy classification?
The Jack L. Fortenberry's specialty field is Counselor, and it falls under the taxonomy code 101Y00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1023155645 to Jack L. Fortenberry?
The Centers for Medicare & Medicaid Services originally issued the 1023155645 to Jack L. Fortenberry on 2007-01-31.
When was the information regarding Jack L. Fortenberry, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Jack L. Fortenberry, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.