Kristy M Forare PSYD LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY7031 Issued in FL

Legal business name

KRISTY M FORARE PSYD LLC

Practice address

1109 W Euclid Ave
Deland, FL 32720-6553

Phone

(386) 943-9040

Fax

(386) 943-9937

NPI assigned

Dec 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kristy Miller Forare, PSY.D.NPI 1205080884

Title

President

Phone

(386) 943-9040

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristy Miller Forare, PSY.D.

  • Clinical Psychologist
  • Deland, FL
  • NPI 1205080884
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1114162070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 W EUCLID AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327206553",
            "telephone_number": "386-943-9040",
            "fax_number": "386-943-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 W EUCLID AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327206553",
            "telephone_number": "386-943-9040",
            "fax_number": "386-943-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTY M FORARE PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "FORARE",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_middle_name": "MILLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-943-9040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Marie Krautheim
• David Allen Krazeise, M.S, ATC, LAT
• Lisa A Krebs, AUD
• Penelope Kremydas, RBT
• Ananth Krishnan, MD
• Thomas M. Kropp, M.D.
• Chaima Kuck, APRN
• Christi Kush, PSY.D.
• Cynthia Kwalwasser, OTR
• Laboratory Corporation of America

• Clinical Psychologist in Deland, FL
• Providers in Deland, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; 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.