Dr. Eli M Forman, PHD
Marriage & Family Therapist in Leonia, New Jersey
1033218714- Practice location
- 431 Park Avenue, Leonia, NJ 07605-1219
- Phone
- 201-592-7388
- Fax
- 201-592-6301
- Last updated
- September 11, 2025
Eli Michael Simong Forman is a Marriage & Family Therapist based in Leonia, NJ. Eli Michael Simong Forman practices in Leonia, NJ and has the professional credentials of PHD. The NPI Number for Eli Michael Simong Forman is 1033218714 and holds a License No. 5688633 (NY). The current practice location address for Eli Michael Simong Forman is 431 Park Avenue, Leonia, NJ 07605-1219 and can be reached out via phone at 201-592-7388 and via fax at 201-592-6301.
Provider Profile Details
- NPI Number
- 1033218714
- Provider Name
- Eli Michael Simong Forman
- Credential
- PHD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 431 Park Avenue, Leonia, NJ 07605-1219
- Phone Number
- 201-592-7388
- Fax Number
- 201-592-6301
- Primary Taxonomy
- Marriage & Family Therapist · 106H00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- September 21, 2006
- Last Update Date
- September 11, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 431 Park Avenue
Leonia, NJ 07605-1219 - City
- Leonia
- State
- New Jersey
- Zip
- 07605-1219
- Phone Number
- 201-592-7388
- Fax Number
- 201-592-6301
Provider Business Mailing Address Details
- Address
- 431 Park Avenue
Leonia, NJ 07605-1219 - City
- Leonia
- State
- NJ
- Zip
- 07605-1219
- Phone Number
- 201-592-7388
- Fax Number
- 201-592-6301
License Information
- License Number (1)
- 5688633
- License State (1)
- NY
- Taxonomy (1)
- Counselor, Mental Health · 101YM0800X
- License Number (2)
- 0019
- License State (2)
- MD
- Taxonomy (2)
- Counselor, Professional · 101YP2500X
- License Number (3)
- M038
- License State (3)
- MD
- Taxonomy (3)
- Marriage & Family Therapist · 106H00000X
- License Number (4)
- MFC13681
- License State (4)
- CA
- Taxonomy (4)
- Marriage & Family Therapist · 106H00000X
- License Number (5)
- 37F100059900
- License State (5)
- NJ
- Taxonomy (5)
- Marriage & Family Therapist · 106H00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Eli M Forman, PHD?
The NPI number of Dr. Eli M Forman, PHD is 1033218714. It was assigned on September 21, 2006 and is currently active in the NPPES registry.
What is the specialty of Dr. Eli M Forman, PHD?
Dr. Eli M Forman, PHD is registered under the primary taxonomy Marriage & Family Therapist (code 106H00000X), licensed in NY under license number 5688633.
Where does Dr. Eli M Forman, PHD practice?
The practice location is 431 Park Avenue, Leonia, NJ 07605-1219. The office can be reached at 201-592-7388 (phone) or 201-592-6301 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1033218714 directly on the NPPES registry website.