Elissia Forty, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SL06845000 Issued in NJ

Practice address

4551 Route 42 Ste 5
Blackwood, NJ 08012-1751

Phone

(856) 271-4490

NPI assigned

Oct 16, 2024

Last updated

Oct 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Equanimity Counseling LLC

  • Professional Counselor
  • Blackwood, NJ
  • NPI 1457074262
  NPD

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1932929502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 PENN BLVD",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962821",
            "telephone_number": "856-271-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4551 ROUTE 42 STE 5",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080121751",
            "telephone_number": "856-271-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTY",
        "first_name": "ELISSIA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06845000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shantaye T Felton
• Victoria Fieni
• Alejandra Rocksett Figueroa, MSW. LSW.
• Tamara Marie Fisicaro, MD
• Lucy Sara Flood, CRNP
• Lorenza Frisoni
• Gintare T Gecys, D.O.
• Cyriac George, D.O.
• Christy Gilcrest
• Lynda Giordano, APN

• Clinical Social Worker in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.