Samuel G. Forlenza, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4029 Issued in NJ

Practice address

94 Valley Rd
First Floor
Montclair, NJ 07042-2211

Phone

(201) 983-1604

NPI assigned

Aug 11, 2006

Sex

Male

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)

Enrolled

Credentials

Doctor of Philosophy

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.

• Guardian Eldercare PC

  • Community/Behavioral Health Agency
  • Hackensack, NJ
  • NPI 1194888008
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1982615944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 PREBLE PL",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070702610",
            "telephone_number": "201-983-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 VALLEY RD",
            "address_2": "FIRST FLOOR",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422211",
            "telephone_number": "201-983-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORLENZA",
        "first_name": "SAMUEL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "4029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Carol Foley, P.T., F.P.
• Tyler Fontan, PT
• Foodtrition LLC
• Forbes Healing LLC
• Jayne Melissa Forbes, DACM, DIPL. AC
• Mary Ann Forster, L.C.S.W.
• Alice Katherine Forsyth, MSW, LCSW
• Franklin Dana Fortunato, MD
• Forward Motion Counseling Services LLC
• Jayne Wendy Foster-Mizraji, D.C.

• Psychologist in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.