Active NPI
Connie Forrester
- Clinical Social Worker
- Apache Junction, AZ
National Provider Identifier
1588057202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW 13620
- Practice address
- 1030 N Valley Dr
Apache Junction, AZ 85120-4059 - Phone
- (480) 707-8213
- NPI assigned
- Mar 5, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW 13620 | AZ | Primary |
Addresses
Primary practice location
1030 N Valley Dr
Apache Junction, AZ 85120-4059
Mailing address
1030 N Valley Dr
Apache Junction, AZ 85120-4059
Phone (480) 707-8213
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW 13620 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425513600000",
"number": "1588057202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 N VALLEY DR",
"city": "APACHE JUNCTION",
"state": "AZ",
"postal_code": "851204059",
"telephone_number": "480-707-8213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 N VALLEY DR",
"city": "APACHE JUNCTION",
"state": "AZ",
"postal_code": "851204059",
"telephone_number": "480-707-8213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORRESTER",
"first_name": "CONNIE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-05",
"last_updated": "2015-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW 13620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apache Junction, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.