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MARY SCHULTZ FORMAN APRN
NPI 1164868030
Clinical Nurse Specialist - Psychiatric/Mental Health in West Haven, CT

Active since May 17, 2013
415 MAIN ST, WEST HAVEN, CT 06516(203) 931-1184(203) 931-0063 Get Directions Write a Review

NPPES record last updated: May 17, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mary Schultz Forman Aprn NPPES

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

MARY SCHULTZ FORMAN APRN (NPI 1164868030) is an individual psychiatric/mental health provider in West Haven, Connecticut, licensed in Connecticut (004082) and active in the NPI registry since May 2013.

NPPES Registry Identity

NPI1164868030
Entity TypeIndividualFemale
Primary Taxonomy364SP0808X
Provider Legal NameMARY SCHULTZ FORMANCredential: APRN
Location Address415 MAIN STWest Haven, CT 06516-4296
Mailing Address661 East StLitchfield, CT 06759-3721 · (860) 733-2828
Phone(203) 931-1184
Fax(203) 931-0063
Sole ProprietorNo
Enumeration DateMay 17, 2013
✔ NPI 1164868030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse Specialist · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364SP0808X
License✔ Licensed in CT · 004082
415 MAIN ST, West Haven, CT 06516
Open in Google Maps ↗

Other Names 1

Professional Name (2)Mary S Forman

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Other Providers at the Same Location NPPES 20

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

BARBARA GALLAGHER JARRY LMFT
Marriage & Family Therapist
415 MAIN ST
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 931-1184
SARAH NICOLE MORAN LCSW
Social Worker (Clinical)
415 MAIN ST
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 931-1184
DR. CHRISTOPHER M INCLIMA O.D.
Optometrist
415 MAIN ST
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 934-5126
JOHN DAVID LIEBERMAN LPC
Counselor (Professional)
415 MAIN ST
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 931-1184
TARIN EVANS
Counselor (Mental Health)
415 MAIN ST
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 931-1184
ALEXANDRA IANNOTTI
Social Worker (Clinical)
415 MAIN ST
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 931-1184
LISA MICHELLE SPEARMAN LCSW
Social Worker (Clinical)
415 MAIN ST
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 931-1184
MS. DEANA THERESA O'BRIEN L.C.S.W.
Social Worker (Clinical)
415 MAIN ST, 5
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 931-1184

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 Mary Forman's NPI number?

The NPI number for Mary Forman is 1164868030. It was assigned to this individual provider in the NPPES registry on May 17, 2013. The provider is also known as Mary S Forman.

Where is Mary Forman located?

Mary Forman practices at 415 Main St, West Haven, CT 06516. The listed phone number is (203) 931-1184.

What is Mary Forman's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Psychiatric/Mental Health, with taxonomy code 364SP0808X.

What insurance does Mary Forman accept?

Health plans from Providence Health Plan list Mary Forman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Forman was last updated on May 17, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.