1. Home
  2. Directory
  3. Arizona
  4. Queen Creek
  5. Community Behavioral Health
  6. NPI Profile

WAYNE A. FORMICA
NPI 1902092422
Community/Behavioral Health in Queen Creek, AZ

Active since September 18, 2007
2055 W FRUIT TREE LN, QUEEN CREEK, AZ 85242(480) 677-4804(480) 677-4804 Get Directions Write a Review

NPPES record last updated: September 18, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wayne A. Formica NPPES

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

WAYNE A. FORMICA (NPI 1902092422) is a healthcare organization registered as a community/behavioral health in Queen Creek, Arizona and active in the NPI registry since September 2007. The organization lists Wayne Arthur Formica, Licensed Professional Counselor, as its authorized official.

NPPES Registry Identity

NPI1902092422
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameWAYNE A. FORMICA
Location Address2055 W FRUIT TREE LNQueen Creek, AZ 85242-6356
Mailing Address2055 W Fruit Tree LnQueen Creek, AZ 85242-6356 · (480) 677-4804 · Fax (480) 677-4804
Phone(480) 677-4804
Fax(480) 677-4804
Organization SubpartNo
Authorized OfficialWayne Arthur FormicaLicensed Professional Counselor · (480) 677-4804
Enumeration DateSeptember 18, 2007
✔ NPI 1902092422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
License✔ Licensed in AZ · LPC 10413
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
2055 W FRUIT TREE LN, Queen Creek, AZ 85242
Open in Google Maps ↗

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 Wayne A. Formica's NPI number?

The NPI number for Wayne A. Formica is 1902092422. It was assigned to this organization in the NPPES registry on September 18, 2007.

Where is Wayne A. Formica located?

Wayne A. Formica is located at 2055 W Fruit Tree Ln, Queen Creek, AZ 85242. The listed phone number is (480) 677-4804.

What is Wayne A. Formica's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Wayne A. Formica was last updated on September 18, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.