Forma LLP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

FORMA LLP

Practice address

3401 12TH St NE Unit 29234
Washington, DC 20017-1127

Phone

(703) 216-0544

NPI assigned

Aug 24, 2023

Organization subpart

No

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

Authorized official

Name

Mr. John JankowskiNPI 1790129807

Title

Co-Owner

Phone

(703) 216-0544

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• John Jankowski, LICSW

  • Clinical Social Worker
  • Washington, DC
  • NPI 1790129807
  NPD Authorized official

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1316721889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 H ST NE STE 2525",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 12TH ST NE UNIT 29234",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200171127",
            "telephone_number": "703-216-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMA LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "JANKOWSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "703-216-0544",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Nchotaku Forka
• Sebastian D Forka
• Patricia Akeahwoa Forku
• Shella A Forkwa
• Regina Ngenyi Forlefac
• Jessica Forman
• Yannick Dodgima Formatum, HHA
• Diriene Ashung Formbat
• Emilia Irene Formoso, B.C.B.A.
• Margaret Christine Formoso, FNP-C

• Clinical Social Worker in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Social Worker in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.