Individual provider Active NPI

Maureen J Forsyth, LCSW-R

  • Clinical Social Worker
  • Ballston Spa, NY
National Provider Identifier
1891949798
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R043296-1 Issued in NY
Practice address
27 Mann Rd
Ballston Spa, NY 12020-3519
Phone
(518) 885-8708
NPI assigned
Nov 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R043296-1 NY Primary

Addresses

Primary practice location

27 Mann Rd
Ballston Spa, NY 12020-3519

Mailing address

27 Mann Rd
Ballston Spa, NY 12020-3519
Phone (518) 885-8708

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R043296-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1891949798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MANN RD",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120203519",
            "telephone_number": "518-885-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MANN RD",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120203519",
            "telephone_number": "518-885-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSYTH",
        "first_name": "MAUREEN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R043296-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Spa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.