BROOKE ANN FORTENBERRY (Credential# 1991663) is licensed (Licensed Clinical Social Worker) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
BROOKE ANN FORTENBERRY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #58.011002. The credential type is licensed clinical social worker. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 155 Constitution St, Wallingford, CT 06492-3826. The current status is active.
| Licensee Name | BROOKE ANN FORTENBERRY |
| Credential ID | 1991663 |
| Credential Number | 58.011002 |
| Credential Type | Licensed Clinical Social Worker |
| Business Address |
155 Constitution St Wallingford CT 06492-3826 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2020-03-30 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1523016 | MSW.004468 | Master's Level Social Worker | 2018-09-16 | 2019-07-01 - 2020-06-30 | ACTIVE IN RENEWAL |
| Street Address | 155 CONSTITUTION ST |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492-3826 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patrick V Mirto Jr · Advance Security Integration Dba Security 101 | 155 Constitution St, Wallingford, CT 06492-3826 | Electrical Limited Contractor | 2019-10-01 ~ 2020-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea Zola | 53 Alison Ave., Wallingford, CT 06492 | Esthetician | ~ |
| Kyungok Choi | 90 Ward St, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Giang Nguyen | 45 Country Club Lane, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-11-30 |
| Lc Artistry | 207 North Colony Road, Wallingford, CT 06492 | Esthetician | ~ |
| Katie Lee | 20 Angela Dr, Wallingford, CT 06492 | Paramedic | 2020-09-01 ~ 2021-08-31 |
| Vinny's Deli | 567 Center St, Wallingford, CT 06492 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Michele Ruggiero | 26 Leigus Road, Wallingford, CT 06492 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Dianna K Ball | 104 Simpson Ave, Wallingford, CT 06492 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Ann Marie Richardson | 20 Mohawk Drive, Wallingford, CT 06492 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Joann Hummel | 60 Deer Run Road, Wallingford, CT 06492 | Medication Administration Certification | 2018-08-21 ~ 2020-08-20 |
| Find all Licenses in zip 06492 | |||
| City | WALLINGFORD |
| Zip Code | 06492 |
| License Type | Licensed Clinical Social Worker |
| License Type + County | Licensed Clinical Social Worker + WALLINGFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brooke E Conley | 32 Hubinger St Fl 1, New Haven, CT 06511-4035 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Brooke C Lombardo | 69b Whitfield St, Guilford, CT 06437-2631 | Licensed Clinical Social Worker | 2020-06-01 ~ 2021-05-31 |
| Brooke E Crum | 45 Lyon Street, New Haven, CT 06511 | Licensed Clinical Social Worker | ~ |
| Brooke C Vargas | 376 North St, Milford, CT 06461-2048 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Brooke L Wenz | 30 Sunset Ln, Wolcott, CT 06716-1517 | Licensed Clinical Social Worker | 2019-09-01 ~ 2020-08-31 |
| Nancy E Dyer | 9-2 Brooke Club Dr, Ossining, NY 10562 | Licensed Clinical Social Worker | 2003-11-03 ~ 2004-11-30 |
| Brooke M Sarno | 92 Balance Rock Rd Apt 14, Seymour, CT 06483-6077 | Licensed Clinical Social Worker | 2019-08-01 ~ 2020-07-31 |
| Brooke R Hammond | 5420 Ne Sandycrest Ter Apt 4, Portland, OR 97213-2650 | Licensed Clinical Social Worker | 2011-01-01 ~ 2011-12-31 |
| Stephanie J Brown | 8422 Town Brooke, Middletown, CT 06457 | Licensed Clinical Social Worker | 2020-02-01 ~ 2021-01-31 |
| Priscilla Brooke Alexander Seessel | 222 Main St # 239, Farmington, CT 06032-3623 | Licensed Clinical Social Worker | 2020-06-01 ~ 2021-05-31 |
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| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).