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KARLIE MICHELLE FORMAN BCBA, LBA
NPI 1154820405
Behavior Analyst in Roselle Park, NJ

Active since February 01, 2018
716 WILLIS PL, ROSELLE PARK, NJ 07204(601) 882-4690 Get Directions Write a Review

NPPES record last updated: August 5, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 5, 2025, May 1, 2023, Sep 22, 2021 (3 updates tracked since 2021).

About Karlie Michelle Forman Bcba, Lba NPPES

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

KARLIE MICHELLE FORMAN BCBA, LBA (NPI 1154820405) is an individual behavior analyst provider in Roselle Park, New Jersey, licensed in Mississippi (1-17-27164) and active in the NPI registry since February 2018.

NPPES Registry Identity

NPI1154820405
Entity TypeIndividualFemale
Primary Taxonomy103K00000X
Provider Legal NameKARLIE MICHELLE FORMANCredential: BCBA, LBA
Location Address716 WILLIS PLRoselle Park, NJ 07204-1227
Mailing Address716 Willis PlRoselle Park, NJ 07204-1227 · (601) 882-4690
Phone(601) 882-4690
Sole ProprietorNo
Enumeration DateFebruary 1, 2018
Last NPPES UpdateAugust 5, 20253 updates tracked since enumeration
NPPES CertifiedAugust 5, 2025
✔ NPI 1154820405 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 MS · 1-17-27164
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.
716 WILLIS PL, Roselle Park, NJ 07204
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Other Providers at the Same Location NPPES

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

DARUMA DREAMS
Behavior Analyst
716 WILLIS PL
ROSELLE PARK, NJ 07204
Union County (908) 248-4450

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 Karlie Forman's NPI number?

The NPI number for Karlie Forman is 1154820405. It was assigned to this individual provider in the NPPES registry on February 1, 2018.

Where is Karlie Forman located?

Karlie Forman practices at 716 Willis Pl, Roselle Park, NJ 07204. The listed phone number is (601) 882-4690.

What is Karlie 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 Karlie Forman was last updated on August 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.