Organization
FORWARD PSYCHOLOGY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON I HERZ PHD (MANAGER)
(608) 833-7533
Entity
Organization
Contact information
Practice address
478 COMMERCE DR, MADISON, WI 53719-4993
(608) 833-7533
Mailing address
478 COMMERCE DR, MADISON, WI 53719-4993
(608) 833-7533
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1715
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SSN
—
Enumeration date
04/11/2007
Last updated
08/22/2020
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