NPIMap

Organization Active NPI

Forward Counseling, PLC

  • Clinical Social Worker
  • Memphis, TN
National Provider Identifier
1407266323
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW0000005676 Issued in TN
Legal business name
FORWARD COUNSELING, PLC
Practice address
560 Colonial Rd Ste 2
Memphis, TN 38117-4019
Phone
(901) 315-8625
Fax
(901) 244-6528
NPI assigned
Apr 30, 2014
Last updated
Apr 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Authorized official

Name
Jessica Shea, LCSWNPI 1679911721
Title
Owner/Manager/Therapist
Phone
(901) 315-8625

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X LSW0000005676 TN Primary

Addresses

Primary practice location

560 Colonial Rd Ste 2
Memphis, TN 38117-4019

Mailing address

560 Colonial Rd Ste 201
Memphis, TN 38117-4097
Phone (901) 930-7397

Other practice location 1

4646 Poplar Ave Ste 203
Memphis, TN 38117-4432
Phone (901) 930-7397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200130001541 TN Part B Supplier - Clinic/Group Practice 1254767890 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

4646 Poplar Ave
Ste 203
Memphis, TN 38117
Phone (901) 683-5511

560 Colonial Rd
Ste 2
Memphis, TN 38117
Phone (901) 315-8625

560 Colonial Rd
Ste 201
Memphis, TN 38117
Phone (901) 310-3911

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1407266323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 COLONIAL RD STE 201",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174097",
            "telephone_number": "901-930-7397",
            "fax_number": "901-244-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 COLONIAL RD STE 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174019",
            "telephone_number": "901-315-8625",
            "fax_number": "901-244-6528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4646 Poplar Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381174432",
            "country_code": "US",
            "telephone_number": "901-930-7397",
            "fax_number": "901-244-6528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FORWARD COUNSELING, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER/MANAGER/THERAPIST",
        "authorized_official_telephone_number": "901-315-8625",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000005676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.