# FORWARD THERAPEUTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053981605
- **Authorized official:** CHUCKEIA FOLLEY LPCC-S (OWNER)
- **Authorized official phone:** (937) 367-4614

## Contact information

- **Practice address:** 118 W 1ST ST STE 308, DAYTON, OH 45402-1150
- **Practice address phone:** (937) 443-7659
- **Practice address fax:** (855) 978-1771
- **Mailing address:** 118 W 1ST ST STE 308, DAYTON, OH 45402-1150
- **Mailing address phone:** (937) 443-7659
- **Mailing address fax:** (855) 978-1771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 06/27/2021
- **Last updated:** 02/08/2024