IndividualActive
Mary Forman, APRN
NPI 1164868030 · Psychiatric/Mental Health Clinical Nurse Specialist · West Haven, CT
Provider details
- NPI number
- 1164868030
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- License
- 004082 (CT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
415 Main St
West Haven, CT 06516-4296
Phone: (203) 931-1184
Fax: (203) 931-0063
Approximate (ZIP-level) locationGet directions
Mailing address
661 East St
Litchfield, CT 06759-3721
Registry dates
- Enumerated
- 2013-05-17
- Last updated
- 2013-05-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.