Individual provider Active NPI

Andrew B Forsyth, PH.D.

  • Clinical Psychologist
  • Spokane, WA
National Provider Identifier
1477653145
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1912 Issued in WA
Practice address
628 S Maple St
Suite 102
Spokane, WA 99204-3445
Phone
(509) 353-9885
Fax
(509) 353-9886
NPI assigned
Sep 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1912 WA Primary

Addresses

Primary practice location

628 S Maple St
Suite 102
Spokane, WA 99204-3445

Mailing address

628 S Maple St
Suite 102
Spokane, WA 99204-3445
Phone (509) 353-9885

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1912WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1477653145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 S MAPLE ST",
            "address_2": "SUITE 102",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992043445",
            "telephone_number": "509-353-9885",
            "fax_number": "509-353-9886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 S MAPLE ST",
            "address_2": "SUITE 102",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992043445",
            "telephone_number": "509-353-9885",
            "fax_number": "509-353-9886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSYTH",
        "first_name": "ANDREW",
        "middle_name": "B",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "1912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.