Active NPI
Robert Eric Forsythe, B. A.
- Mental Health Counselor
- Jackson, TN
National Provider Identifier
1992845978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 24 Weatherford SQ
Jackson, TN 38305-2202 - Phone
- (731) 660-6723
- Fax
- (731) 661-9152
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
24 Weatherford SQ
Jackson, TN 38305-2202
Mailing address
33 Brooksie Drive
Jackson, TN 38305
Phone (731) 660-5242
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth Villages, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Bartlett, TN
- NPI 1306875695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992845978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 BROOKSIE DRIVE",
"city": "JACKSON",
"state": "TN",
"postal_code": "38305",
"telephone_number": "731-660-5242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 WEATHERFORD SQ",
"city": "JACKSON",
"state": "TN",
"postal_code": "383052202",
"telephone_number": "731-660-6723",
"fax_number": "731-661-9152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORSYTHE",
"first_name": "ROBERT",
"middle_name": "ERIC",
"name_prefix": "Mr.",
"credential": "B. A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.