Laurie M Forman, MS SOCIAL WORK

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R0317371 Issued in NY

Practice address

2631 Merrick Rd
Ste 205
Bellmore, NY 11710

Phone

(516) 679-6673

Fax

(516) 679-6673

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nassau Guidance Counseling and Licensed Clinical Social Work ServicesGroup PAC ID 1658408448, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989

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.

• Nassau Guidance Counseling & Licensed Clinical Social Work Services PC

  • Clinical Social Worker
  • Merrick, NY
  • NPI 1609923515
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962508291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2631 MERRICK RD",
            "address_2": "STE 205",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "11710",
            "telephone_number": "516-679-6673",
            "fax_number": "516-679-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2631 MERRICK RD",
            "address_2": "STE 205",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "11710",
            "telephone_number": "516-679-6673",
            "fax_number": "516-679-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "LAURIE",
        "middle_name": "M",
        "credential": "MS SOCIAL WORK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0317371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244817",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Fleischer
• Margaret J Flores, M.A.
• Jordan Fred Fogel
• For Yourself Holistic Rejuvenation Center
• Howard Wayne Forman, LCSW
• Eileen Mary Foronjy, M.A.
• Sheila C Fowler
• Isaac France, BT
• Mavis Franco
• Rhea Frankie

• Clinical Social Worker in Bellmore, NY
• Providers in Bellmore, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.