Carolina Forman, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39004862A Issued in IN

Practice address

3876 E 650 N
Marion, IN 46952-9181

Phone

(765) 517-4991

NPI assigned

Nov 10, 2021

Last updated

Jun 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Neossia Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1295396810
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1023774338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3876 E 650 N",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469529181",
            "telephone_number": "765-517-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3876 E 650 N",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469529181",
            "telephone_number": "765-517-4991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 S Scott Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468149702",
            "country_code": "US",
            "telephone_number": "260-358-7180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "CAROLINA",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004862A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie F Flynn, PTA
• Kelly M Folbrecht, LPN
• Lily Ford, RBT
• Christine Marie Fording, BA, MATS
• Forefront Dermatology, S.C.
• Evan Forshey, RBT
• Randy Fortkamp, OD
• R. Nathaniel Foster, PHD, ATC, LAT
• Andrew Fowler
• Stacy Lynn Fox

• Mental Health Counselor in Marion, IN
• Providers in Marion, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.