Lauren Alexis Formy-Duval, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3357 Issued in NC

Practice address

1502 W NC Highway 54
Suite 302
Durham, NC 27707-5571

Phone

(919) 475-9629

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265760000000",
    "number": "1588718530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54",
            "address_2": "SUITE 302",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075571",
            "telephone_number": "919-475-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54",
            "address_2": "SUITE 302",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075571",
            "telephone_number": "919-475-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMY-DUVAL",
        "first_name": "LAUREN",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2010-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUESHIELD",
            "identifier": "14067",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2397097",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001043",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Forester-Miller, PHD
• Sarah Forester
• Erin Forfa, PT, DPT
• Davita Paula Forman, PA-C
• Leslie M Forman I, M.D.
• Christopher Robert Forrest, MD, FRCSC, FACS, FRA
• Michael Tcheupdjian Forrester, MD, PHD
• Ann Forsthoefel, FNP
• Julia Louise Forstner, PA
• Ana Forsythe

• Clinical Psychologist in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; 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.