Provider Demographics
NPI:1205570280
Name:FORWARD HEALING PLLC
Entity type:Organization
Organization Name:FORWARD HEALING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ELMQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:806-910-8090
Mailing Address - Street 1:9301 HIGHLAND SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-7952
Mailing Address - Country:US
Mailing Address - Phone:806-626-1717
Mailing Address - Fax:
Practice Address - Street 1:6900 W I 40 STE 304B
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2539
Practice Address - Country:US
Practice Address - Phone:806-910-8090
Practice Address - Fax:806-410-2890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty