NPIMap

Organization Active NPI

Forward Wellness Family Therapy, Inc.

  • Community/Behavioral Health Agency
  • Placentia, CA
National Provider Identifier
1093398059
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FORWARD WELLNESS FAMILY THERAPY, INC.
Practice address
1041 E Yorba Linda Blvd Ste 202
Placentia, CA 92870-3760
Phone
(800) 701-0937
NPI assigned
Apr 28, 2021
Last updated
Apr 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Authorized official

Name
Katherine M Wismer, LMFTNPI 1245394774
Title
Owner/Program Director
Phone
(800) 701-0937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1041 E Yorba Linda Blvd Ste 202
Placentia, CA 92870-3760

Mailing address

1041 E Yorba Linda Blvd Ste 202
Placentia, CA 92870-3760
Phone (800) 701-0937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230530002815 CA Part B Supplier - Clinic/Group Practice 9739546144 Receives reassigned benefits from 136 practitioners
Practice locations: Placentia, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 147

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 147

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1093398059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 E YORBA LINDA BLVD STE 202",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703760",
            "telephone_number": "800-701-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 E YORBA LINDA BLVD STE 202",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703760",
            "telephone_number": "800-701-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORWARD WELLNESS FAMILY THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "WISMER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "800-701-0937",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.