Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACK L. FORTENBERRY, LMSW
ActiveMR. JACK L. FORTENBERRY, LMSW is a Counselor healthcare provider located in CHOCTAW, Oklahoma. NPI 1023155645 is currently active in the NPPES registry. Verify at CMS.
Counselor · CHOCTAW, OK
Registration Details
- NPI Number
- 1023155645
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 31, 2007 (19.35009076671 yrs)
- Last Updated
- Jul 8, 2007
- License
-
3030 (OK)
Practice Information
- Address
-
14625 NE 23RD STREETCHOCTAW, OK, 73020Browse OK providers · Browse ZIP 73020
- Phone
- 4053908131
- Fax
- 4053908134
- Primary Specialty
-
Counselor
101Y00000X
Other Counselor Providers in CHOCTAW, OK
| Name | Credential | NPI |
|---|---|---|
| JENNIFER CONNER | — | 1043437163 |
| MS. EILEEN RUTH WEIDES | LADC ICAADC | 1487852414 |
| MR. DONALD EARL BREWER | CERTIFIED A& D INSTR | 1669670691 |
| MRS. HELEN MARIE ALLRED | LPC | 1508189465 |
| GAYLA ANN GIVENS | MAMFT | 1386960219 |
| MRS. CRISTINA MICHELLE HOLLOWAY | MA, LMFT CANDIDATE | 1619269255 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.