MINDY FORMAN PSYD
NPI 1851768725
Psychologist in Libertyville, IL

Active since August 27, 2015PECOS Enrolled
1248 AMERICAN WAY, LIBERTYVILLE, IL 60048(224) 433-6744 Get Directions Write a Review

NPPES record last updated: December 13, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mindy Forman Psyd NPPES

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

MINDY FORMAN PSYD (NPI 1851768725) is an individual psychologist in Libertyville, Illinois, licensed in Illinois (071.009917) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1851768725
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameMINDY FORMANCredential: PSYD
Location Address1248 AMERICAN WAYLibertyville, IL 60048-3936
Mailing Address1248 American WayLibertyville, IL 60048-3936 · (224) 433-6744
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateAugust 27, 2015
Last NPPES UpdateDecember 13, 2018
NPI 1851768725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in IL · 071.009917
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedCounselorTaxonomy 101Y00000X
1248 AMERICAN WAY, Libertyville, IL 60048

Other Identifiers 1

Medicaid1851768725IL

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

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

PECOS PAC ID5890034763
PECOS Enrollment IDI20190312001003
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 16

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

Counselor (Mental Health)
1248 AMERICAN WAY
LIBERTYVILLE, IL 60048
Counselor (Professional)
1248 AMERICAN WAY, SUITE B
LIBERTYVILLE, IL 60048
Counselor (Mental Health)
1248 AMERICAN WAY
LIBERTYVILLE, IL 60048
Psychologist (Clinical)
1248 AMERICAN WAY
LIBERTYVILLE, IL 60048
Psychologist (Clinical)
1248 AMERICAN WAY
LIBERTYVILLE, IL 60048
Psychologist (Clinical)
1248 AMERICAN WAY
LIBERTYVILLE, IL 60048
Counselor (Professional)
1248 AMERICAN WAY
LIBERTYVILLE, IL 60048
Social Worker
1248 AMERICAN WAY
LIBERTYVILLE, IL 60048

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 Forman's NPI number?

The NPI number for Mindy Forman is 1851768725. It was assigned to this individual provider in the NPPES registry on August 27, 2015.

Where is Mindy Forman located?

Mindy Forman practices at 1248 American Way, Libertyville, IL 60048. The listed phone number is (224) 433-6744.

What is Mindy Forman's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Mindy Forman enrolled in Medicare?

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

What insurance does Mindy Forman accept?

Health plans from UnitedHealthcare list Mindy 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 Mindy Forman was last updated on December 13, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.