Nicole Rae Forsyth, AMFT 128339

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

128339 Issued in CA

Practice address

1396 W Herndon Ave # Sut110
Fresno, CA 93711-7126

Phone

(559) 256-0100

NPI assigned

Dec 9, 2015

Sex

Female

Sole proprietor

Yes

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 and National Provider Directory roles.

• Kings View

  dba Metro Cit

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1982162731
  NPD (past)

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1952776403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1396 W HERNDON AVE # SUT110",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937117126",
            "telephone_number": "559-256-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1396 W HERNDON AVE # SUT110",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937117126",
            "telephone_number": "559-256-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1925 E Dakota Ave Ste Q",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937264821",
            "country_code": "US",
            "telephone_number": "559-256-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORSYTH",
        "first_name": "NICOLE",
        "middle_name": "RAE",
        "name_prefix": "Miss",
        "credential": "AMFT 128339",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "128339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Christiane Forman, APCC
• Ashley Fornaro
• Dana Jo Forred, NP-C
• Walter A Forred, MD
• Branden Scott Forrest
• James Clark Forsythe, MD
• Victoria Forsythe
• Fort Miller Middle School
• Dana Suzanne Fortier, LCSW
• Lydia Jane Fortner, PTA

• Marriage & Family Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.