Andrew John Fort, LPC
Individual provider Active NPI Professional Counselor · Tabernacle, NJ
NPI 1306529136 · NPPES record last updated Aug 9, 2023
Key facts
- NPI
- 1306529136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 37PC00968300 (NJ)
- Practice address
- 1 Pin Oak CT
Tabernacle, NJ 08088-8514 - Phone
- (609) 932-6073
- NPI assigned
- Aug 9, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00968300 | NJ | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00968300 | NJ | Yes |
Addresses
Primary practice location
1 Pin Oak CT
Tabernacle, NJ 08088-8514
Mailing address
1 Pin Oak CT
Tabernacle, NJ 08088-8514
Phone (609) 932-6073
Other providers in Tabernacle, NJ
- Sharlene Demartini-Guth
- Erin Donoghue
- Lauren Rose Ellis
- Ernco Inc
- Evolve Foot and Ankle
- Colin J Fort
- Katherine Amanda Fox
- Friends of Cyrus II Inc
- Friends of Cyrus II Inc
- Friends of Cyrus II Inc
All providers in Tabernacle, NJ · Professional Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.