Jodi Ellen Forman is a Clinical in Marietta, Georgia. Jodi Ellen Forman practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jodi Ellen Forman is 1245396217. The last update date is 2007-07-08.
Jodi Ellen Forman's current location address is 122 Cherry St Ne, Marietta, Georgia. You can contact this provider via phone number 4042724261 and fax number 7704222302. The mailing address for Jodi Ellen Forman is 122 Cherry St Ne, Marietta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jodi Ellen Forman |
|---|---|
| Address | 122 Cherry St Ne, Marietta, Georgia |
| Phone Number | 4042724261 |
| Fax Number | 7704222302 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1245396217 |
|---|---|
| Provider Enumeration Date | 2006-12-27 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 122 Cherry St Ne |
|---|---|
| City | Marietta |
| State | Georgia (GA) |
| Post Code | 300607206 |
| Phone Number | 4042724261 |
| Fax Number | 7704222302 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 2835 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique 10-digit identification code issued to Jodi Ellen Forman by the Centers for Medicare & Medicaid Services?
The Jodi Ellen Forman has been assigned the NPI (National Provider Identifier) 1245396217 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Jodi Ellen Forman is located?
The Jodi Ellen Forman is situated at the following address: 122 Cherry St Ne, Marietta, GA, 300607206.
What is Jodi Ellen Forman's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Jodi Ellen Forman is Clinical, and the taxonomy code that classifies this field of practice is 1041C0700X.
On what date was the 1245396217 assigned to Jodi Ellen Forman?
The Jodi Ellen Forman was issued its 1245396217 on 2006-12-27, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Jodi Ellen Forman, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jodi Ellen Forman, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC