1. Home
  2. Directory
  3. Oklahoma
  4. Choctaw
  5. Counselor
  6. NPI Profile

MR. JACK L. FORTENBERRY LMSW
NPI 1023155645
Counselor in Choctaw, OK

Active since January 31, 2007
14625 NE 23RD STREET, CHOCTAW, OK 73020(405) 390-8131(405) 390-8134 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Jack L. Fortenberry Lmsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JACK L. FORTENBERRY LMSW (NPI 1023155645) is an individual counselor in Choctaw, Oklahoma, licensed in Oklahoma (3030) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1023155645
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameMR. JACK L. FORTENBERRYCredential: LMSW
Location Address14625 NE 23RD STREETChoctaw, OK 73020
Mailing AddressPo Box 695Choctaw, OK 73020-0695 · (405) 390-8131 · Fax (405) 390-8134
Phone(405) 390-8131
Fax(405) 390-8134
Sole ProprietorNo
Enumeration DateJanuary 31, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1023155645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in OK · 3030
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
14625 NE 23RD STREET, Choctaw, OK 73020
Open in Google Maps ↗

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. CHRIS LAMONT DOUGLAS MASTER SOCIAL WORK
Counselor (Mental Health)
14625 NE 23RD STREET
CHOCTAW, OK 73020
Oklahoma County (405) 390-8131
MRS. MENDI J MILLS BASOCIOLOGY
Counselor (Mental Health)
14625 NE 23RD STREET
CHOCTAW, OK 73020
Oklahoma County (405) 390-8131
MR. VERNON L PIERCE M.ED
Counselor (Mental Health)
14625 NE 23RD STREET
CHOCTAW, OK 73020
Oklahoma County (405) 390-8131

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Fortenberry's NPI number?

The NPI number for Jack Fortenberry is 1023155645. It was assigned to this individual provider in the NPPES registry on January 31, 2007.

Where is Jack Fortenberry located?

Jack Fortenberry practices at 14625 NE 23rd Street, Choctaw, OK 73020. The listed phone number is (405) 390-8131.

What is Jack Fortenberry's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Jack Fortenberry was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.