Forman Psychological Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

0810005256 Issued in VA

Legal business name

FORMAN PSYCHOLOGICAL SERVICES LLC

Practice address

2800 N Parham Rd Ste 107
Richmond, VA 23294-4409

Phone

(804) 554-1760

NPI assigned

Oct 5, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Rebekah Forman, PH.D.

Title

Licensed Clinical Psychologist

Phone

(804) 554-1760

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507161600000",
    "number": "1326558297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N PARHAM RD STE 107",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232944409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N PARHAM RD STE 107",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232944409",
            "telephone_number": "804-554-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMAN PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-05",
        "last_updated": "2017-10-05",
        "status": "A",
        "authorized_official_last_name": "FORMAN",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "804-554-1760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "VA",
            "license": "0810005256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forest Hill Family Practice, Inc.
• Heather Ann Forestiere, PT
• Forever Living Assistant Care Home Corp.
• Jane Kristine Foreyt, PT, DPT
• Laura Garawski Forlano, DO, MPH
• Casey Forman
• Jared Forman, SLP
• Rebekah Forman, PH.D.
• Formation PT & Performance PLLC
• Louis Formica, D.D.S.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Richmond, VA
• Providers in Richmond, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; 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.