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MR. SAMUEL AUSTIN FORMANEK
NPI 1811595259
Counselor - Mental Health in New York, NY

Active since October 16, 2020
248 W 108TH ST, NEW YORK, NY 10025(212) 663-3000 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Samuel Austin Formanek NPPES

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

MR. SAMUEL AUSTIN FORMANEK (NPI 1811595259) is an individual mental health provider in New York, New York, licensed in New York (P107181) and active in the NPI registry since October 2020.

NPPES Registry Identity

NPI1811595259
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. SAMUEL AUSTIN FORMANEK
Location Address248 W 108TH STNew York, NY 10025-2956
Mailing Address41 Corell RdScarsdale, NY 10583-7448 · (191) 484-4297
Phone(212) 663-3000
Sole ProprietorYes
Enumeration DateOctober 16, 2020
Last NPPES UpdateNovember 27, 2023
NPPES CertifiedOctober 13, 2020
✔ NPI 1811595259 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · P107181
248 W 108TH ST, New York, NY 10025
Open in Google Maps ↗

Other Identifiers 2

OtherP107181NY · Ny State License Permit
MedicaidP107181NY

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.

CHIARA SKY SMITH
Student in an Organized Health Care Education/Training Program
248 W 108TH ST
NEW YORK, NY 10025
New York County (212) 663-3000
KIZZY MASSEY
Counselor (Mental Health)
248 W 108TH ST
NEW YORK, NY 10025
New York County (212) 663-3000
JAMIE ADORNO
Registered Nurse
248 W 108TH ST
NEW YORK, NY 10025
New York County (212) 663-3000
MS. PAULA SCOTT LMSW
Social Worker (Clinical)
248 W 108TH ST
NEW YORK, NY 10025
New York County (212) 663-3000
MADELEINE SEDLACK
Nurse Practitioner
248 W 108TH ST
NEW YORK, NY 10025
New York County (212) 663-3000
SHARON GOLD PLAUE LCSW
Social Worker (Clinical)
248 W 108TH ST
NEW YORK, NY 10025
New York County (212) 663-3000
MR. JOHN JAMES JACKSON LMSW
Counselor (Addiction (Substance Use Disorder))
248 W 108TH ST
NEW YORK, NY 10025
New York County (212) 663-3000
MS. LISA FERRARI LCSW
Social Worker (Clinical)
248 W 108TH ST
NEW YORK, NY 10025
New York County (212) 663-3000

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 Samuel Formanek's NPI number?

The NPI number for Samuel Formanek is 1811595259. It was assigned to this individual provider in the NPPES registry on October 16, 2020.

Where is Samuel Formanek located?

Samuel Formanek practices at 248 W 108th St, New York, NY 10025. The listed phone number is (212) 663-3000.

What is Samuel Formanek's specialty?

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

What insurance does Samuel Formanek accept?

Health plans from Providence Health Plan list Samuel Formanek 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 Samuel Formanek was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.