Gary G Forrest, PHD EDD

Individual provider Active NPI Psychologist · Cosps, CO

NPI 1447320718 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1447320718
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
361 (CO)
Practice address
3208 N Academy Blvd
160
Cosps, CO 80917-5176
Phone
(719) 597-5959
Fax
(719) 597-0166
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
361COMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychotherapy Associates Psychologist Past
since Jan 1, 1990
Accepting new patients
Psychotherapy Associates Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 361 CO Yes

Addresses

Primary practice location

3208 N Academy Blvd
160
Cosps, CO 80917-5176

Mailing address

3208 N Academy Blvd
160
Cosps, CO 80917-5176
Phone (719) 597-5959

Other providers in Cosps, CO

All providers in Cosps, CO · Psychologist in Colorado

Sources for this page

Verify at the official NPI Registry.