DR. STEPHANIE RAE FORNESS (NPI# 1275545527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275545527 |
| Entity Type | Individual |
| Full Name | DR. STEPHANIE RAE FORNESS |
| Other Name | MS. STEPHANIE RAE FABER |
| Credential | PSYD, LP |
| Practice Address |
1212 E College Dr Marshall MN 56258-2010 |
| Mailing Address |
408 S Whitney St Marshall MN 56258-1932 |
| Practice Telephone | 5075323236 |
| Practice Fax Number | 5075320240 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
LP-4345 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | SIOUX VALLEY HEALTH | 41552 | 01 |
| MN | HEALTH PARTNERS | HP49480 | 01 |
| MN | UCARE | 136319 | 01 |
| MN | PREFERRED ONE | 1043064 | 01 |
| MN | BLUE CROSS BLUE SHIELD | 948S3FO | 01 |
| Street Address |
1212 E COLLEGE DR |
| City | MARSHALL |
| State | MN |
| Zip Code | 56258-2010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679559819 | Mark W Chapman | Counselor | 1212 E College Dr, Marshall, MN 56258-2010 | 2005-12-20 |
| 1497372718 | Kathleen Raml | Social Worker | 1212 E College Dr, Marshall, MN 56258-2010 | 2020-07-02 |
| 1376172189 | Amy King | Social Worker | 1212 E College Dr, Marshall, MN 56258-2010 | 2020-04-03 |
| 1669023693 | Scena Dethlefs | Counselor | 1212 E College Dr, Marshall, MN 56258-2010 | 2019-09-20 |
| 1336704451 | Mark Bigaouette | Counselor | 1212 E College Dr, Marshall, MN 56258-2010 | 2019-05-03 |
| 1104480599 | Megan Benedict | Counselor | 1212 E College Dr, Marshall, MN 56258-2010 | 2019-05-01 |
| 1881153641 | Danyelle Caliguire | Counselor | 1212 E College Dr, Marshall, MN 56258-2010 | 2019-03-19 |
| 1982178307 | Christina Jean Lustfield | Counselor | 1212 E College Dr, Marshall, MN 56258-2010 | 2019-01-18 |
| 1609340025 | Mahlon Michael Mace | Counselor | 1212 E College Dr, Marshall, MN 56258-2010 | 2019-01-18 |
| 1831693092 | Angela J Przybilla | Social Worker | 1212 E College Dr, Marshall, MN 56258-2010 | 2018-03-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285140012 | Action Manufacturing Inc | Durable Medical Equipment & Medical Supplies | 1105 Lake Road, Marshall, MN 56258 | 2017-12-15 |
| 1124579123 | Themarshrx | Durable Medical Equipment & Medical Supplies | 600 Sherman Ave, Marshall, MN 56258 | 2016-10-14 |
| 1780020370 | Heritage Pointe Senio | Assisted Living Facility | 207 N 4th Street, Marshall, MI 56258 | 2013-05-22 |
| 1528351178 | Lori Anne Lynner | Family Medicine | 3160 Us Hwy 59, Marshall, MN 56258 | 2011-05-16 |
| 1912148545 | Tami J Behnke | Counselor | 1418 State Street, Campus Religious Center, Marshall, MN 56258 | 2009-03-11 |
| 1073768396 | Sharyce Marie Audiology Inc | Audiologist | 1424 East College Drive, Suite 200, Marshall, MN 56258 | 2008-12-01 |
| 1497976625 | Erica Anne Jost | Specialist/Technologist | 1501 State Street, Marshall, MN 56258 | 2007-05-02 |
| 1265597470 | Nancy Louise Hemmingson | Optometrist | 300 S Bruce Street, Avera Marshall Southwest Ophthalmology, Marshall, MN 56258 | 2006-12-27 |
| 1407928187 | Midwest Vision Centers Inc | Technician/Technologist | 1113 E College Drive, Marshall, MN 56258 | 2006-11-15 |
| 1306918354 | Paul Joseph Puetz | Chiropractor | 111 Jewett St, Marshall, MN 56258 | 2006-11-14 |
| Find all providers in zip 56258 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023358645 | Kory Alexander Holzer | Psychologist | 1212 E College Dr, Marshall, MN 56258-2010 | 2013-02-19 |
| 1386829364 | Cynthia Lynn Cassidy | Psychologist | 1212 E College Dr, Marshall, MN 56258-2010 | 2008-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355275 | Paul Franklin Singh | Psychologist | 150 E Travelers Trl Ste G, Burnsville, MN 55337-6890 | 2020-10-29 |
| 1639779127 | Abdifatah Nuuh | Psychologist | 4204 16th Ave S, Minneapolis, MN 55407-3312 | 2020-10-26 |
| 1134732514 | Colleen Cashen | Psychologist | 1341 Cleveland Ave S, Saint Paul, MN 55116-2653 | 2020-08-26 |
| 1295357440 | Pure Potential Counseling | Psychologist | 18685 Dylan Dr, Farmington, MN 55024-7070 | 2020-05-11 |
| 1871115337 | Melissa Jean King | Psychologist | 205 W 2nd St Ste 437, Duluth, MN 55802-1922 | 2020-05-07 |
| 1841811296 | Kristen Math X | Psychologist | 1603 Pebble Creek Dr, Sartell, MN 56377-4538 | 2020-04-27 |
| 1245859982 | Thomas Allen | Psychologist | 12 Valley View Pl, Mankato, MN 56001-2500 | 2020-04-13 |
| 1033749163 | Neurocalm, LLC | Psychologist | 3153 Hennepin Ave Ste 211, Minneapolis, MN 55408-2620 | 2020-01-16 |
| 1457999500 | Megan Robb | Psychologist | 555 W Broadway Ave Ste 2and3, Forest Lake, MN 55025-1175 | 2019-12-18 |
| 1821635723 | Leadership Coaching Institute LLC | Psychologist | 1264 Garden St, Ogilvie, MN 56358-3520 | 2019-12-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.