Colleen Lynn Fornear, PMHNP- BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RNP279264 Issued in AZ

Practice address

3636 N Central Ave
Phoenix, AZ 85012-1927

Phone

(602) 234-3733

NPI assigned

Aug 17, 2022

Last updated

Oct 10, 2023By 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

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Serenity TMS Centers LLCGroup PAC ID 0840550596, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Serenity TMS Centers LLC

  dba Serenity Mental Health Centers

  • Psychiatry Physician
  • Lehi, UT
  • NPI 1710492095

  AZ

  Medicare reassignment Care Compare group NPD
• Spectrum Healthcare Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cottonwood, AZ
  • NPI 1487635389

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Spectrum Healthcare Group, Inc

  • Psychiatry Physician
  • Prescott, AZ
  • NPI 1285148502

  Psychiatric/Mental Health

  NPD
• Spectrum Healthcare Group, Inc

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1912614413

  Psychiatric/Mental Health

  NPD
• Spectrum Healthcare Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
  • NPI 1831811850

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1962120774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121927",
            "telephone_number": "602-234-3733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7400 S Power Rd Ste 126",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852979283",
            "country_code": "US",
            "telephone_number": "480-482-7350",
            "fax_number": "480-482-7370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORNEAR",
        "first_name": "COLLEEN",
        "middle_name": "LYNN",
        "credential": "PMHNP- BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-17",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RNP279264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Forkum
• Shannon Forman
• Blake Garrison Formanek, MD
• Formation Chiropractic, LLC
• Russell Fornator, CCP
• Lucas Christien Fornefeld
• Ryan James Forney, MD
• Jason R Forni, DPM
• Eleonora Forns
• Shahyar Foroughi, DDS

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.