Healthcare Provider Details

I. General information

NPI: 1376451880
Provider Name (Legal Business Name): FORWARD MOVEMENT HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5014 FOREST PINES DR
UPPER MARLBORO MD
20772-2688
US

IV. Provider business mailing address

5014 FOREST PINES DR
UPPER MARLBORO MD
20772-2688
US

V. Phone/Fax

Practice location:
  • Phone: 240-428-9191
  • Fax:
Mailing address:
  • Phone: 240-428-9191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KEONIE MORRISEY
Title or Position: MANAGING MEMBER
Credential:
Phone: 240-428-9191