Individual provider Active NPI

Katelynn Forney

  • Professional Counselor
  • Modesto, CA
National Provider Identifier
1912722752
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
AMFT152868 Issued in CA
Practice address
2000 W Briggsmore Ave Ste I
Modesto, CA 95350-3839
Phone
(209) 526-1476
NPI assigned
Nov 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X AMFT152868 CA Primary

Addresses

Primary practice location

2000 W Briggsmore Ave Ste I
Modesto, CA 95350-3839

Mailing address

2000 W Briggsmore Ave Ste I
Modesto, CA 95350-3839
Phone (209) 526-1476

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
AMFT152868CAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1912722752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W BRIGGSMORE AVE STE I",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503839",
            "telephone_number": "209-526-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BRIGGSMORE AVE STE I",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503839",
            "telephone_number": "209-526-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNEY",
        "first_name": "KATELYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-18",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "AMFT152868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

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

Verify at the official NPI Registry.