Provider Demographics
NPI:1316051311
Name:FORBUSH, WENDY J (MSW)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:J
Last Name:FORBUSH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-2320
Mailing Address - Country:US
Mailing Address - Phone:508-994-8214
Mailing Address - Fax:
Practice Address - Street 1:4364 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-4614
Practice Address - Country:US
Practice Address - Phone:508-998-2700
Practice Address - Fax:508-998-2176
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW 1070251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
772233OtherTUFTS
8872-01OtherPACIFICARE (HARVAD PILGRI
6223137OtherUNITED BEHAVIORAL HEALTH
008003OtherVALUE OPTIONS
RI410260OtherBLUE CHIP OF BCBS RI
032119000OtherMAGELLAN
1019230OtherBEACON HEALTH
RI3173-2OtherBLUE CROSS BLUE SHIELD RI
1019230OtherBEACON HEALTH