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BROOKE FORTENBERRY LCSW
NPI 1700415379
Social Worker - Clinical in Orange, CT

Active since April 06, 2020PECOS Enrolled
240 INDIAN RIVER RD STE C, ORANGE, CT 06477(203) 497-3867(203) 298-0494 Get Directions Write a Review

NPPES record last updated: April 6, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Brooke Fortenberry Lcsw NPPES

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

BROOKE FORTENBERRY LCSW (NPI 1700415379) is an individual clinical provider in Orange, Connecticut, licensed in Connecticut (11002) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700415379
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameBROOKE FORTENBERRYCredential: LCSW
Location Address240 INDIAN RIVER RD STE COrange, CT 06477-3649
Mailing Address240 Indian River Rd Ste COrange, CT 06477-3649 · (203) 497-3867 · Fax (203) 298-0494
Phone(203) 497-3867
Fax(203) 298-0494
Sole ProprietorNo
Enumeration DateApril 6, 2020
NPPES CertifiedApril 6, 2020
✔ NPI 1700415379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CT · 11002
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
240 INDIAN RIVER RD STE C, Orange, CT 06477
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brooke Fortenberry Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Brooke Fortenberry reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Impact Health P.C.
0.1 mi
Nurse Practitioner
240 INDIAN RIVER RD STE C7
Orange, CT 06477
  • Reassigned Medicare billing, Connecticut enrollment
  • Medicare enrollment name: Impact Health PC
  • 129 clinicians in this Medicare group
NPI 1730694316 (203) 497-3861
Impact Health Psych PC
0.1 mi
Psychiatric/Mental Health
240 INDIAN RIVER RD STE C7
Orange, CT 06477
  • Reassigned Medicare billing, Connecticut enrollment
  • 46 clinicians in this Medicare group
NPI 1730781022 (203) 497-3861

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 30 minutes 90832
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.
256 services45 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
61 services60 patients
Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
52 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06477 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $60.82 – $183.10
Typical copayment $0.00 (range $15.20 – $45.77)
Most-billed visit code NA
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Brooke Fortenberry's NPI number?

The NPI number for Brooke Fortenberry is 1700415379. It was assigned to this individual provider in the NPPES registry on April 6, 2020.

Where is Brooke Fortenberry located?

Brooke Fortenberry practices at 240 Indian River Rd Ste C, Orange, CT 06477. The listed phone number is (203) 497-3867.

What is Brooke Fortenberry's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Brooke Fortenberry enrolled in Medicare?

Yes. Brooke Fortenberry is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Brooke Fortenberry's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brooke Fortenberry reassigns Medicare benefits to 2 organizations: Impact Health P.C. (Orange, CT) and Impact Health Psych PC (Orange, CT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Brooke Fortenberry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Brooke Fortenberry was last updated on April 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.