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MINDY E FORMAN PSYD PLLC
NPI 1225639990
Clinic/Center - Mental Health (Including Community Mental Health Center) in Deerfield, IL

Active since November 07, 2020
1020 MILWAUKEE AVE STE 126, DEERFIELD, IL 60015(248) 703-4880 Get Directions Write a Review

NPPES record last updated: April 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 7, 2020, Nov 15, 2020, Nov 7, 2020 (3 updates tracked since 2020).

About Mindy E Forman Psyd Pllc NPPES

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

MINDY E FORMAN PSYD PLLC (NPI 1225639990) is a healthcare organization registered as a mental health (including community mental health center) in Deerfield, Illinois and active in the NPI registry since November 2020. The organization lists Mindy Erin Forman, Clinical Psychologisy, as its authorized official.

NPPES Registry Identity

NPI1225639990
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameMINDY E FORMAN PSYD PLLC
Location Address1020 MILWAUKEE AVE STE 126Deerfield, IL 60015-3561
Mailing Address255 Bristol CtDeerfield, IL 60015-4850 · (248) 703-4880
Phone(248) 703-4880
Organization SubpartNo
Authorized OfficialMindy Erin FormanClinical Psychologisy · (248) 703-4880
Enumeration DateNovember 7, 2020
Last NPPES UpdateApril 18, 20253 updates tracked since enumeration
NPPES CertifiedApril 18, 2025
✔ NPI 1225639990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
1020 MILWAUKEE AVE STE 126, Deerfield, IL 60015
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mindy E Forman Psyd Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mindy E Forman Psyd PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mindy Forman, PSYD
Clinical Psychologist
NPI 1851768725
1248 AMERICAN WAY
Libertyville, IL 60048
(224) 433-6744
✔ PECOS10 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Mindy E Forman Psyd PLLC's NPI number?

The NPI number for Mindy E Forman Psyd PLLC is 1225639990. It was assigned to this organization in the NPPES registry on November 7, 2020.

Where is Mindy E Forman Psyd PLLC located?

Mindy E Forman Psyd PLLC is located at 1020 Milwaukee Ave Ste 126, Deerfield, IL 60015. The listed phone number is (248) 703-4880.

What is Mindy E Forman Psyd PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Mindy E Forman Psyd PLLC enrolled in Medicare?

Yes. Mindy E Forman Psyd PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mindy E Forman Psyd PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Mindy E Forman Psyd PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mindy E Forman Psyd PLLC was last updated on April 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.