Mindy Forman, PSYD - Medicare Counselor in Libertyville, IL

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Mindy Forman, PSYD is a medicare enrolled "Psychologist" provider in Libertyville, Illinois. She graduated from healthcare school in 2013 and has 11 years of diverse experience with area of expertise as Clinical Psychologist. Her current practice location is 1248 American Way, Libertyville, Illinois. You can reach out to her office (for appointments etc.) via phone at (224) 433-6744.

Mindy Forman is licensed to practice in Illinois (license number 071.009917) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1851768725.

Contact Information

Mindy Forman, PSYD
1248 American Way,
Libertyville, IL 60048-3936
(224) 433-6744
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameMindy Forman
GenderFemale
SpecialityClinical Psychologist
Experience11 Years
Location1248 American Way, Libertyville, Illinois
Accepts Medicare AssignmentsMay be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mindy Forman graduated from medical school in 2013
  NPI Data:
  • NPI Number: 1851768725
  • Provider Enumeration Date: 08/27/2015
  • Last Update Date: 12/13/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 5890034763
  • Enrollment ID: I20190312001003

Medical Identifiers

Medical identifiers for Mindy Forman such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1851768725NPI-NPPES
1851768725MedicaidIL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101Y00000XCounselor (* (Not Available))Secondary
103T00000XPsychologist 071.009917 (Illinois)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mindy Forman allows following entities to bill medicare on her behalf.
Entity NameKelly Behrends, Psyd, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962632463
PECOS PAC ID: 5991858516
Enrollment ID: O20090729000897
Entity NameMindy E Forman Psyd Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1225639990
PECOS PAC ID: 3173934916
Enrollment ID: O20201130000600

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mindy Forman is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mindy Forman, PSYD
1248 American Way,
Libertyville, IL 60048-3936

Ph: (224) 433-6744		Mindy Forman, PSYD
1248 American Way,
Libertyville, IL 60048-3936

Ph: (224) 433-6744

Reviews and Comments


Psychologist in Libertyville, IL


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.