Individual
DAVID W FORTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
600 W MORRISON ST, FAYETTE, MO 65248-1075
(660) 248-3313
(600) 248-3313
Mailing address
117 N GARTH AVE, COLUMBIA, MO 65203-4103
(573) 443-2204
(573) 875-5851
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
001328
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22241
BCBS
MO
01
—
326443
HEALTHLINK
MO
Enumeration date
07/19/2005
Last updated
07/13/2007
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