Active NPI
Pamela Mills Forman, PH.D.
- Psychologist
- Chevy Chase, MD
National Provider Identifier
1366689788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 04186
- Practice address
- 4843 Langdrum Lane
Chevy Chase, MD 20815 - Phone
- (301) 657-3475
- NPI assigned
- Jan 8, 2009
- Last updated
- Jan 8, 2009
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 04186 | MD | Primary |
Addresses
Primary practice location
4843 Langdrum Lane
Chevy Chase, MD 20815
Mailing address
4843 Langdrum Lane
Chevy Chase, MD 20815
Phone (301) 657-3475
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04186 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231372800000",
"number": "1366689788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4843 LANGDRUM LANE",
"city": "CHEVY CHASE",
"state": "MD",
"postal_code": "20815",
"telephone_number": "301-657-3475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4843 LANGDRUM LANE",
"city": "CHEVY CHASE",
"state": "MD",
"postal_code": "20815",
"telephone_number": "301-657-3475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMAN",
"first_name": "PAMELA",
"middle_name": "MILLS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-08",
"last_updated": "2009-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "04186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chevy Chase, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.