Active NPI
Lisa Michele Forman, M.S.
- Mental Health Counselor
- Hyannis, MA
National Provider Identifier
1265651335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 206 Breeds Hill Rd
Hyannis, MA 02601-1881 - Phone
- (508) 775-0275
- NPI assigned
- Apr 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
206 Breeds Hill Rd
Hyannis, MA 02601-1881
Mailing address
38 Lisa Ave
Plymouth, MA 02360-5016
Phone (508) 747-8137
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associates in Behavioral Health, LLC | Current | Accepting new patients | |
| Massachusetts Society for the Prevention of Cruelty to Children | Past | Accepting new patients |
Locations
7 Dean St
Taunton, MA 02780
Phone (508) 822-0006
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Taunton, MA
- NPI 1922164854
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Boston, MA
- NPI 1285712596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265651335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 LISA AVE",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023605016",
"telephone_number": "508-747-8137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 BREEDS HILL RD",
"city": "HYANNIS",
"state": "MA",
"postal_code": "026011881",
"telephone_number": "508-775-0275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMAN",
"first_name": "LISA",
"middle_name": "MICHELE",
"name_prefix": "Mrs.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hyannis, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.