David Lionel Forstadt, PSYD, LPC, CASAC

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

805 E Broward Blvd Ste 301
Fort Lauderdale, FL 33301-2046

Phone

(323) 205-5345

NPI assigned

May 9, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1093982092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 NE 14TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333011275",
            "telephone_number": "716-908-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E BROWARD BLVD STE 301",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012046",
            "telephone_number": "323-205-5345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "544 NE 14th Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333011275",
            "country_code": "US",
            "telephone_number": "323-205-5345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORSTADT",
        "first_name": "DAVID",
        "middle_name": "LIONEL",
        "name_prefix": "Dr.",
        "credential": "PSYD, LPC, CASAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-09",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "25987",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0016363",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC.9293",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH.18797",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.drdavidforstadt.com",
            "affiliation": "N",
            "endpointDescription": "direct url",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "544 NE 14th Ave",
            "city": "Fort Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333011275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jordan Forre
• Gary Miles Forrest, LMFT, SAP
• Mackenzie Forrest
• Forrester Homecare, LLC
• Forrester Homecare, LLC
• Fort Lauderdale Addiction Treatment Center
• Fort Lauderdale Chiropractic Center
• Fort Lauderdale Counseling Services, Inc
• Fort Lauderdale Dermatology, PLLC
• Fort Lauderdale DMS

• Psychologist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.