Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | NC | |
N | 103K00000X | Behavior Analyst | NC | |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | NC | |
N | 103TE1100X | Exercise & Sports Psychologist | NC | |
N | 103TF0000X | Family Psychologist | NC | |
N | 103TH0100X | Health Service | NC | |
N | 103TP2701X | Group Psychotherapist | NC |
NPI | 1528312733 |
---|---|
Provider Name | Mr. Carl Lee Forte |
First Address | Raleigh, NC 27604-6155 |
Second Address | Raleigh, NC 27604-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2012 |
Last Update Date | 09/11/2012 |