Sherry R Forzley, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-16-21690 Issued in IN

Practice address

912 Middlebury St
Goshen, IN 46528-2739

Phone

(574) 383-0107

Fax

(877) 804-8654

NPI assigned

Jun 25, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1164837340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 MIAMI ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466141336",
            "telephone_number": "574-234-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 MIDDLEBURY ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465282739",
            "telephone_number": "574-383-0107",
            "fax_number": "877-804-8654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORZLEY",
        "first_name": "SHERRY",
        "middle_name": "R",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-16-21690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sherry@virtus.health",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "912 Middlebury St",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465282739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsey Fisher
• Ruth Fisher, NP
• Sheila M Fleming, NP
• Esmeralda Flores, MSED
• Fogg Health and Wellness
• Lynda Fourman, CADAC IV
• Cory Douglas Fournier, MA-CMHC
• Scott Fowler
• Kim Annette Fox, RPH
• Edith A Fraire, MSN, RN, FNP-BC

• Behavior Analyst in Goshen, IN
• Providers in Goshen, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.