Erica Carman Formway, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

114590 Issued in CA

Practice address

920 Mendocino Ave Ste 8
Santa Rosa, CA 95401-4860

Phone

(707) 595-0244

NPI assigned

Apr 24, 2015

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

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1043607286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 MENDOCINO AVE STE 8",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014860",
            "telephone_number": "707-595-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MENDOCINO AVE STE 8",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014860",
            "telephone_number": "707-595-0244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "819 3rd St",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954044545",
            "country_code": "US",
            "telephone_number": "707-303-3549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMWAY",
        "first_name": "ERICA",
        "middle_name": "CARMAN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forestream Acupuncture & Herbs
• William James Formaker, MFT
• Justin David Forman, B.S.
• Sherri Ann Forman, CAADE
• Formative Care, Inc.
• James Joseph Forni, D.D.S.
• Mary Anne Donato Forni, D.M.D.
• Jared R Fortman, DDS
• Kellie Robin Foss, RDN
• Amy Elizabeth Fossell

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.