Individual provider Active NPI

Blair Cristin Forte

  • Marriage & Family Therapist
  • Port Jefferson, NY
National Provider Identifier
1376307918
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
06-P127066-01 Issued in NY
Practice address
1000 Main St
First Floor, South Suite
Port Jefferson, NY 11777
Phone
(631) 296-1113
NPI assigned
Feb 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 06-P127066-01 NY Primary

Addresses

Primary practice location

1000 Main St
First Floor, South Suite
Port Jefferson, NY 11777

Mailing address

1000 Main St
First Floor, South Suite
Port Jefferson, NY 11777-2250
Phone (631) 296-1113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260407001407 NY Practitioner - Marriage and Family Therapist 2769957802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1377 Motor Pkwy
Suite 102
Islandia, NY 11749-5249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06-P127066-01NYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Emdr LCSW P.C. PastSince Jan 26, 2025 Accepting new patients
Resilient Counseling LCSW PC PastSince Feb 1, 2024 Accepting new patients
CS Medical Associates, P.C. PastSince Feb 28, 2026 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1376307918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MAIN ST",
            "address_2": "FIRST FLOOR, SOUTH SUITE",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772250",
            "telephone_number": "631-296-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAIN ST",
            "address_2": "FIRST FLOOR, SOUTH SUITE",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "11777",
            "telephone_number": "631-296-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTE",
        "first_name": "BLAIR",
        "middle_name": "CRISTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "06-P127066-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

Verify at the official NPI Registry.