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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DOMINIQUE FORSMAN

Active Sole Proprietor

DOMINIQUE FORSMAN is a Mental Health Counselor healthcare provider located in CHURCHTON, Maryland. NPI 1972321180 is currently active in the NPPES registry. Verify at CMS.

Mental Health Counselor · CHURCHTON, MD

Registration Details

NPI Number
1972321180
Provider Type
Individual
Gender
Female
NPI Issued
Sep 27, 2024 (1.9142955792828 yrs)
Last Updated
Sep 27, 2024
Licenses
LGP15666 (MD)
LGP15666 (MD)
Sole Proprietor
Yes

Practice Information

Address
5419 DEALE CHURCHTON RD STE 104
CHURCHTON, MD, 207332408
Browse MD providers · Browse ZIP 20733
Phone
4105416686
Primary Specialty
Mental Health Counselor
101YM0800X
Additional Specialty
Mental Health Counselor
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.