Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Sherry R Forzley , BCBA

Behavior Analyst β€’ Goshen, IN

Active NPI 1164837340 Individual Practitioner Female Practitioner
Practice location in NPPES

912 Middlebury St
Goshen, IN 465282739

Call 5743830107 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

912 Middlebury St

Goshen, IN 465282739

Telephone 5743830107
Fax 8778048654
Organization at the Same NPPES Address or Phone
Autism Services Of Michiana Llc Facility NPI 1982059069

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2014

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Goshen and Indiana

15 active clinicians are listed under Behavior Analyst with a practice address in Goshen, IN (2,152 in Indiana).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Goshen

0% of these 15 clinicians have the CMS telehealth indicator.

0% of these 15 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2020-01-03
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

License # reported to NPPES IN 1-16-21690

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Indiana Professional Licensing Agency.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location January 03, 2020

Registered at 912 MIDDLEBURY ST, GOSHEN, IN 465282739 (Tel: 5743830107)

πŸ‘€
Provider Name / Credentials Updated January 03, 2020

Recorded as SHERRY FORZLEY, BCBA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 03, 2020

Behavior Analyst (license number reported to NPPES: IN 1-16-21690)

βœ…
NPI Profile Active June 25, 2014

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 25, 2014

Registered at 2314 MIAMI ST, SOUTH BEND, IN 466141336 (Tel: 5742349282)

πŸ“
Business Mailing Address (Initial Record) June 25, 2014

Registered at 2314 MIAMI ST, SOUTH BEND, IN 466141336 (Tel: 5742349282)

πŸ‘€
Provider Name / Credentials (Initial Record) June 25, 2014

Recorded as SHERRY FORZLEY, BCABA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2014

Behavior Analyst (license number reported to NPPES: IN 0-14-5982)

🟒
Initial NPI Registration & Enumeration June 25, 2014

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1164837340
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 25, 2014
Last Update: January 03, 2020
Sole Proprietor: Yes

Mailing Address

2314 Miami St

South Bend, IN 466141336

Phone: 5742349282

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.