Laura G Forman, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810001083 Issued in VA

Practice address

327 W 21St St
Suite 205
Norfolk, VA 23517-2130

Phone

(757) 622-9852

Fax

(757) 622-4033

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Laura G Roberto-Forman Other name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1979

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Laura G Forman, Psy.D, Fapa, LLC

  • Clinical Psychologist
  • Norfolk, VA
  • NPI 1376288571
  Medicare reassignment NPD Authorized official
• Eileen M Osgood, LCSW, LLC

  • Clinical Social Worker
  • Norfolk, VA
  • NPI 1538807821
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346322674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 W 21ST ST",
            "address_2": "SUITE 205",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235172130",
            "telephone_number": "757-622-9852",
            "fax_number": "757-622-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 W 21ST ST",
            "address_2": "SUITE 205",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235172130",
            "telephone_number": "757-622-9852",
            "fax_number": "757-622-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "LAURA",
        "middle_name": "G",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007734301",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "ROBERTO-FORMAN",
            "middle_name": "G",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robin L Fore-Martin
• Erica Denise Foreman, LPC
• Jatashsa Lanee Foreman, RDH
• Sara B Forgione, BA RBT
• Forkids,Inc.
• Erin Formanski
• Sarah Elizabeth Forsythe
• Fort Norfolk Plaza Medical Associates, LLC
• Fort Norfolk Plaza Medical Associates, LLC
• Fort Norfolk Plaza Medical Associates, LLC

• Clinical Psychologist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Clinical Psychologist in Virginia

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.