Elissa Forman is a Clinical in Belfast, Maine. Elissa Forman practices all healthcare services and medical treatments related to Clinical. The NPI Number for Elissa Forman is 1578532438. The last update date is 2014-06-04.
Elissa Forman's current location address is Po Box 5700, Belfast, Maine. You can contact this provider via phone number 8664314077 and fax number 4137747448. The mailing address for Elissa Forman is Po Box 5700, Belfast, Maine. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Elissa Forman |
|---|---|
| Address | Po Box 5700, Belfast, Maine |
| Phone Number | 8664314077 |
| Fax Number | 4137747448 |
| Sole Proprietor | N |
| Credentials | LICSW |
NPI Number Detail
| NPI Number | 1578532438 |
|---|---|
| Provider Enumeration Date | 2006-03-14 |
| Last Updated Date | 2014-06-04 |
Provider Mailing Address Detail
| Address | Po Box 5700 |
|---|---|
| City | Belfast |
| State | Maine (ME) |
| Post Code | 49155700 |
| Phone Number | 8664314077 |
| Fax Number | 4137747448 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 1031672 |
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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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 102517 | MA | FALLON | |
| 3172516 | MA | CIGNA BEHAVIORAL HEALTH | |
| 468597 | MA | TUFTS HEALTH PLAN | |
| P07575 | MA | BLUE CROSS BLUE SHIELD | |
| 33214 | MA | HEALTH NEW ENGLAND | |
| 593372000 | MA | MAGELLAN BEHAVIORAL HEALT |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Elissa Forman by the Centers for Medicare & Medicaid Services?
The Elissa Forman has been issued the NPI (National Provider Identifier) 1578532438 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Elissa Forman?
The Elissa Forman is situated at Po Box 5700, in the city of Belfast, state of ME, with the zip code 49155700.
What is Elissa Forman's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Elissa Forman's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1578532438 to Elissa Forman?
The Centers for Medicare & Medicaid Services originally issued the 1578532438 to Elissa Forman on 2006-03-14.
As of what date was the information pertaining to Elissa Forman, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Elissa Forman, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2014-06-04.