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DALE FORMAN
NPI 1023432457
Behavior Analyst in Eagle River, AK

Active since February 05, 2014
12836 OLD GLENN HWY, EAGLE RIVER, AK 99577(907) 726-5330 Get Directions Write a Review

NPPES record last updated: February 5, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dale Forman NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DALE FORMAN (NPI 1023432457) is an individual behavior analyst provider in Eagle River, Alaska, licensed in South Carolina (0-13-5716) and active in the NPI registry since February 2014.

NPPES Registry Identity

NPI1023432457
Entity TypeIndividualFemale
Primary Taxonomy103K00000X
Provider Legal NameDALE FORMAN
Location Address12836 OLD GLENN HWYEagle River, AK 99577-7041
Mailing Address13541 Charmley CirEagle River, AK 99577 · (334) 685-4506
Phone(907) 726-5330
Sole ProprietorYes
Enumeration DateFebruary 5, 2014
✔ NPI 1023432457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers
Taxonomy Code103K00000X
License✔ Licensed in SC · 0-13-5716
Definition
A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
12836 OLD GLENN HWY, Eagle River, AK 99577
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Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MELODIE CELESTE RADCLIFFE BCBA
Behavior Analyst
12836 OLD GLENN HWY
EAGLE RIVER, AK 99577
Anchorage Municipality (907) 726-5330
MRS. EMILY GRACE RADEWAHN BA, BCABA
Behavior Analyst
12836 OLD GLENN HWY
EAGLE RIVER, AK 99577
Anchorage Municipality (907) 726-5330
JULIE SARICH BCBA
Behavior Analyst
12836 OLD GLENN HWY
EAGLE RIVER, AK 99577
Anchorage Municipality (907) 726-5330
WHITNEY L WATSON
Case Manager/Care Coordinator
12836 OLD GLENN HWY
EAGLE RIVER, AK 99577
Anchorage Municipality (907) 696-0123
SELECT PHYSICAL THERAPY HOLDINGS INC
Durable Medical Equipment & Medical Supplies
12836 OLD GLENN HWY, SUITE 101
EAGLE RIVER, AK 99577
Anchorage Municipality (717) 975-4503
EMMA NAOMI BOSWELL M.A., CCC-SLP
Speech-Language Pathologist
12836 OLD GLENN HWY
EAGLE RIVER, AK 99577
Anchorage Municipality (907) 726-5330
JENNA CHRISTINE RHODES BHS BCABA
Behavior Analyst
12836 OLD GLENN HWY
EAGLE RIVER, AK 99577
Anchorage Municipality (907) 726-5366
ALEXIS TERESITA WEILAND CCC-SLP
Speech-Language Pathologist
12836 OLD GLENN HWY
EAGLE RIVER, AK 99577
Anchorage Municipality (907) 717-5193

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dale Forman's NPI number?

The NPI number for Dale Forman is 1023432457. It was assigned to this individual provider in the NPPES registry on February 5, 2014.

Where is Dale Forman located?

Dale Forman practices at 12836 Old Glenn Hwy, Eagle River, AK 99577. The listed phone number is (907) 726-5330.

What is Dale Forman's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

When was this NPI record last updated?

The NPPES record for Dale Forman was last updated on February 5, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.