Active NPI
Marjorie Forman, LCSW LP
- Psychoanalyst
- New York, NY
National Provider Identifier
1790865301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalyst
- License
- 000232-1
- Practice address
- 150 E 39TH St
Suite 808
New York, NY 10016-0933 - Phone
- (212) 779-0462
- Fax
- (631) 287-6346
- NPI assigned
- Oct 17, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R021152 | NY | |
| Psychoanalyst | 102L00000X | 000232-1 | NY | Primary |
Addresses
Primary practice location
150 E 39TH St
Suite 808
New York, NY 10016-0933
Mailing address
150 E 39TH St
Suite 808
New York, NY 10016-0933
Phone (212) 779-0462
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000232-1 | NY | MD | Psychoanalyst |
| R021152 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1790865301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 E 39TH ST",
"address_2": "SUITE 808",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100160933",
"telephone_number": "212-779-0462",
"fax_number": "631-287-6346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 E 39TH ST",
"address_2": "SUITE 808",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100160933",
"telephone_number": "212-779-0462",
"fax_number": "631-287-6346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMAN",
"first_name": "MARJORIE",
"name_prefix": "Ms.",
"credential": "LCSW LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R021152",
"primary": false
},
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "NY",
"license": "000232-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.