Healthcare Provider Details

I. General information

NPI: 1962828152
Provider Name (Legal Business Name): NOLLECA FORBES FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LYONS AVE
NEWARK NJ
07112-2027
US

IV. Provider business mailing address

829 2ND PL
PLAINFIELD NJ
07060-2507
US

V. Phone/Fax

Practice location:
  • Phone: 973-926-2445
  • Fax:
Mailing address:
  • Phone: 908-754-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00465900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number26NJ00465900
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00465900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: