MS. KATRINA FORMAN (NPI# 1447538269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447538269 |
| Entity Type | Individual |
| Full Name | MS. KATRINA FORMAN |
| Credential | MSW |
| Practice Address |
4302 Hollywood Blvd # 127 Hollywood FL 33021-6635 |
| Mailing Address |
4302 Hollywood Blvd Ste 127 Hollywood FL 33021-6635 |
| Practice Telephone | 9545050554 |
| Practice Fax Number | 9545050554 |
| Mailing Telephone | 9545050554 |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2018-02-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | FL | Behavioral Health & Social Service Providers | |
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Street Address |
4302 HOLLYWOOD BLVD # 127 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-6635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699271650 | Roxanna Katherine Dunn | Social Worker | 1722 Dewey St Apt B, Hollywood, FL 33020-6119 | 2018-03-30 |
| 1649715210 | Amanda Yard | Social Worker | 1754 Taft Ave, Hollywood, CA 90028-5705 | 2017-01-05 |
| 1568913127 | Aliza Adivi | Social Worker | 1690 Weeping Willow Way, Hollywood, FL 33019-4845 | 2016-10-19 |
| 1912341090 | Julinel Plaza | Social Worker | 5928 Sheridan St Ste B, Hollywood, FL 33021-3246 | 2013-04-19 |
| 1891035630 | Alison Nyman | Social Worker | 3325 Hollywood Blvd Ste 503, Hollywood, FL 33021-6926 | 2013-02-14 |
| 1063711521 | Ian Walter Holloway | Social Worker | 6138 Franklin Ave # Lb318, Hollywood, CA 90028-5247 | 2011-03-23 |
| 1275719247 | Maria Fernanda Londono | Social Worker | 1437 Lee St, Hollywood, FL 33020-2235 | 2008-01-21 |
| 1063616043 | Suzzy Brooks | Social Worker | 2421 Hollywood Blvd, Hollywood, FL 33020-6605 | 2007-06-13 |
| 1255965984 | Britni Kelly Summers | Social Worker | 3400 N 29th Ave, Hollywood, FL 33020-1002 | 2020-03-03 |
| 1265064059 | Leydibet Torres Gonzalez | Social Worker | 7777 Davie Road Ext Ste 105b, Hollywood, FL 33024-2523 | 2020-02-10 |
| Find all providers in HOLLYWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.