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EMILY BRONSON FORMAN
NPI 1104372879
Counselor - Mental Health in Middletown, CT

Active since August 31, 2016
230 MAIN STREET EXT, MIDDLETOWN, CT 06457(860) 343-5303 Get Directions Write a Review

NPPES record last updated: August 31, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Emily Bronson Forman NPPES

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

EMILY BRONSON FORMAN (NPI 1104372879) is an individual mental health provider in Middletown, Connecticut and active in the NPI registry since August 2016.

NPPES Registry Identity

NPI1104372879
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameEMILY BRONSON FORMAN
Location Address230 MAIN STREET EXTMiddletown, CT 06457-4470
Mailing Address230 Main Street Extension P.0. Box 1000Middletown, CT 06457 · (860) 343-5303
Phone(860) 343-5303
Sole ProprietorNo
Enumeration DateAugust 31, 2016
✔ NPI 1104372879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
230 MAIN STREET EXT, Middletown, CT 06457
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Other Providers at the Same Location NPPES 11

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

MR. SEAN ANDREW FORBES MSW
Social Worker
230 MAIN STREET EXT
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 769-7077
MONIKA EILEEN OBERMEIER LPC
Counselor (Mental Health)
230 MAIN STREET EXT
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 343-5303
EDWARD URETA
Counselor (Addiction (Substance Use Disorder))
230 MAIN STREET EXT
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 343-5304
LAUREL J GUERTIN LCSW
Social Worker (Clinical)
230 MAIN STREET EXT
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 343-5300
AVREY C. JUNTILLA-SMITH LMFT-A
Marriage & Family Therapist
230 MAIN STREET EXT
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 343-5303
GILEAD COMMUNITY SERVICES, INC.
Community/Behavioral Health
230 MAIN STREET EXT
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 343-5300
PSYCHIATRY ASSOCIATES OF CONNECTICUT
Psychologist (Prescribing (Medical))
230 MAIN STREET EXT
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (203) 245-1579
GILEAD COMMUNITY SERVICES, INC.
Clinic/Center (Adult Mental Health)
230 MAIN STREET EXT
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 343-5300

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 Emily Forman's NPI number?

The NPI number for Emily Forman is 1104372879. It was assigned to this individual provider in the NPPES registry on August 31, 2016.

Where is Emily Forman located?

Emily Forman practices at 230 Main Street Ext, Middletown, CT 06457. The listed phone number is (860) 343-5303.

What is Emily Forman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Emily Forman was last updated on August 31, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.