Active NPI
Forrest Arnie Willis, LMHC
- Mental Health Counselor
- Davie, FL
National Provider Identifier
1821909698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 28241
- Practice address
- 1712 SW 103Rd LN
Davie, FL 33324-7466 - Phone
- (252) 339-0285
- NPI assigned
- Sep 12, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 28241 | FL | Primary |
Addresses
Primary practice location
1712 SW 103Rd LN
Davie, FL 33324-7466
Mailing address
1712 SW 103Rd LN
Davie, FL 33324-7466
Phone (252) 339-0285
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789171200000",
"number": "1821909698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1712 SW 103RD LN",
"city": "DAVIE",
"state": "FL",
"postal_code": "333247466",
"telephone_number": "252-339-0285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1712 SW 103RD LN",
"city": "DAVIE",
"state": "FL",
"postal_code": "333247466",
"telephone_number": "252-339-0285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "FORREST",
"middle_name": "ARNIE",
"name_prefix": "Mr.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-12",
"last_updated": "2026-09-12",
"certification_date": "2026-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "28241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.