SUSAN FORMAN (NPI# 1912010877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912010877 |
| Entity Type | Individual |
| Full Name | SUSAN FORMAN |
| Credential | LCSW |
| Practice Address |
270 Amity Rd Suite 130 Woodbridge CT 06525 |
| Practice Telephone | 2033970064 |
| Practice Fax Number | 2033973537 |
| Mailing Telephone | 2033970064 |
| Mailing Fax Number | 2033973537 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | 001232 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CAQ0H | 11585299 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710101787 | Susan M Forman | Specialist | 8305 Walnut Hill Ln, Suite 210, Dallas, TX 75231-4217 | 2007-04-12 |
| Street Address |
270 AMITY RD SUITE 130 |
| City | WOODBRIDGE |
| State | CT |
| Zip Code | 06525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578593497 | Harvey Lee Ruben | Psychiatry & Neurology | 270 Amity Rd, Suite 130, Woodbridge, CT 06525 | 2006-07-04 |
| 1386197010 | Serenity Counseling LLC | Social Worker | 270 Amity Rd, Suite 130, Woodbridge, CT 06525-2236 | 2016-07-29 |
| 1336581800 | Michel Jean-baptiste, Md, LLC | Counselor | 270 Amity Rd, Suite 132, Woodbridge, CT 06525-2236 | 2013-07-24 |
| 1275883647 | Harvey L. Ruben, Mdpc | Nurse Practitioner | 270 Amity Rd, Suite 130, Woodbridge, CT 06525 | 2012-09-13 |
| 1003126277 | Dr. Benjamin Szczypek, LLC | Chiropractor | 270 Amity Rd, Suite 132, Woodbridge, CT 06525-2236 | 2010-10-20 |
| 1801056940 | Robert M. Glassman | Specialist | 270 Amity Rd, Suite 219, Woodbridge, CT 06525-2236 | 2008-06-12 |
| 1962523837 | Louis Cofrancesco | Chiropractor | 270 Amity Rd, Suite 132, Woodbridge, CT 06525-2236 | 2007-04-02 |
| 1184744427 | Harvey L. Ruben,md PC | Psychiatry & Neurology | 270 Amity Rd, 130, Woodbridge, CT 06525-2236 | 2007-03-30 |
| 1174657027 | Jamie Marie Loehfelm | Counselor | 270 Amity Rd, Woodbridge, CT 06525-2236 | 2007-03-15 |
| 1467599753 | Constance L Mindell | Social Worker | 270 Amity Rd, Suite 220, Woodbridge, CT 06525-2236 | 2007-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649838822 | Arcadian Counseling, LLC | Counselor | 176 Amity Rd # 283, Woodbridge, CT 06525 | 2019-06-03 |
| 1538604566 | Susan G Israel | Psychiatry & Neurology | 18 Carriage Hill Road, Woodbridge, CT 06525 | 2016-12-29 |
| 1417409947 | Personal Care Training LLC | Home Health | 30 Hazel Terace #7, Woodbridge, CT 06525 | 2016-11-01 |
| 1538506324 | James A Killian | Counselor | 1 Bradley Rd Ste 106, Woodbridge, CT 06525 | 2013-06-03 |
| 1154666063 | Julie M Charron | Physical Therapy Assistant | 5 Spring Valley Rd, Woodbridge, CT 06525 | 2012-12-04 |
| 1780931022 | Edward David Martino | Dentist | 1674 Litchfield Turnpike, Woodbridge, CT 06525 | 2012-08-06 |
| 1972864627 | Sandra Boltax-stern, Md, PC | Psychiatry & Neurology | 78 Ansonia Road, Woodbridge, CT 06525 | 2012-05-30 |
| 1629383906 | Innovative Healthcare | Exclusive Provider Organization | 555 Amity Rd., Woodbridge, CT 06525 | 2010-08-11 |
| 1437300225 | Carl B. Lundborg | Orthopaedic Surgery | 4 Fox Hill Rd, Woodbridge, CT 06525 | 2008-10-10 |
| 1033366067 | Richard Eubanks Fearon | Internal Medicine | 20 Brook Rd, Woodbridge, CT 06525 | 2008-08-21 |
| Find all providers in zip 06525 | ||||
| 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 |
|---|---|---|---|---|
| 1598379000 | Chloe Taylor Smith | Social Worker | 19 Fox Den Way, Woodbridge, CT 06525-1904 | 2020-09-02 |
| 1982111449 | Frances Davis | Social Worker | 4196 Merchant Plaza Apt 632, Woodbridge, VA 22193 | 2018-01-05 |
| 1639449879 | Frances P Johnson | Social Worker | 12315 Pond Run Dr, #204, Woodbridge, VA 22192-7067 | 2012-01-05 |
| 1841591609 | Mallory Anne Grimste | Social Worker | 30 Hazel Ter, Suite 12, Woodbridge, CT 06525-2240 | 2010-11-10 |
| 1558548057 | Charmaine Samuda | Social Worker | 30 Hazel Ter Ste 10, Woodbridge, CT 06525-2240 | 2008-01-28 |
| 1265587331 | Sarah Monteleone | Social Worker | 1 Bradley Rd Ste 905, Woodbridge, CT 06525-2296 | 2007-01-25 |
| 1003982653 | Betty G Austen | Social Worker | 30 Barberry Ln, Woodbridge, CT 06525 | 2006-11-27 |
| 1023124526 | Evelyn M Hatfield | Social Worker | 15941 Donald Curtis Drive, Suite 200, Woodbridge, VA 22191 | 2006-08-21 |
| 1730157207 | Vicki Johnson | Social Worker | 16354 Rusty Rudder Dr, Woodbridge, VA 22191-6357 | 2006-03-10 |
| 1144837592 | Kristen Lorentzen | Social Worker | 300 Kimball St Ste 106, Woodbridge, NJ 07095-2506 | 2020-09-29 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 06525 |
Please comment or provide details below to improve the information on SUSAN FORMAN.
| 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.