Healthcare Provider Details

I. General information

NPI: 1700428976
Provider Name (Legal Business Name): DAVID JAMES FORNOS LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2019
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7004 BEE CAVES RD UNIT 200
AUSTIN TX
78746-5004
US

IV. Provider business mailing address

1722 WOODWARD ST APT 215
AUSTIN TX
78741-7819
US

V. Phone/Fax

Practice location:
  • Phone: 512-306-1394
  • Fax:
Mailing address:
  • Phone: 210-200-9469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number81376
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: