Individual
MS. MARJORIE FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW LP
Contact information
Practice address
150 E 39TH ST, SUITE 808, NEW YORK, NY 10016-0933
(212) 779-0462
(631) 287-6346
Mailing address
150 E 39TH ST, SUITE 808, NEW YORK, NY 10016-0933
(212) 779-0462
(631) 287-6346
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
000232-1
NY
1041C0700X
Clinical Social Worker
R021152
NY
Other
Enumeration date
10/17/2006
Last updated
09/11/2025
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