Families Forward LLC

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY003096 Issued in GA

Legal business name

FAMILIES FORWARD LLC

Practice address

3711 Executive Center Dr
Suite 101
Martinez, GA 30907-0951

Phone

(706) 210-8855

Fax

(678) 541-7699

NPI assigned

Aug 27, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Dara A Delancy, PSY.D.

Title

Psychologist

Phone

(706) 210-8855

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy Holsten, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Augusta, GA
  • NPI 1053665356
  NPD (past)

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1962750869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 EXECUTIVE CENTER DR",
            "address_2": "SUITE 101",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070951",
            "telephone_number": "706-210-8855",
            "fax_number": "678-541-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 EXECUTIVE CENTER DR",
            "address_2": "SUITE 101",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070951",
            "telephone_number": "706-210-8855",
            "fax_number": "678-541-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILIES FORWARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "DELANCY",
        "authorized_official_first_name": "DARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "706-210-8855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "PSY003096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "447024026C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Essence Personal Care Home
• April S Evans, OTRL
• Helen Evans
• Tamela Evans, NCC, LPC, ED.D.
• Betty Jeane Exume, LPC
• Angiselis Lourdes Feliciano Martell
• Fenixx in Flow
• Tiffany Few
• Caroline Fickling, OTR/L
• First Focus Faith, LLC

• Clinical Child & Adolescent Psychologist in Martinez, GA
• Providers in Martinez, GA by specialty
• Clinical Child & Adolescent Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.