Mark Edwin Forrest, L.I.C.S.W.

Primary specialty

Social WorkerTaxonomy code 104100000X

License

110768 Issued in MA

Practice address

330 Brookline Ave
Beth Israel Deaconess Medical Center/East
Boston, MA 02215

Phone

(617) 667-7000

Fax

(617) 667-8665

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487667705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 NORRIS ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401814",
            "telephone_number": "617-354-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BETH ISRAEL DEACONESS MEDICAL CENTER/EAST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-667-7000",
            "fax_number": "617-667-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORREST",
        "first_name": "MARK",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "110768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Raymond Formanek III, MD
• Cintia Fornasaro
• Kristin D Forner, M.D.
• Julia Foro, PA-C
• Louisa Mahlon Forrest, AUD
• Suzanne Jaqueth Forrest, M.D.
• B. Lachlan Forrow, M.D.
• Elizabeth Grace Forsen, MD
• Deborah Anne Forst, M.D.
• Forsyth Dental Infirmary for Children

• Social Worker in Boston, MA
• Providers in Boston, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.