=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770778102
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FCP INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/10/2007
-----------------------------------------------------
Last Update Date | 07/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 112 W. MAIN STREET
-----------------------------------------------------
City | JASONVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47438-1514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-240-0939
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 515
-----------------------------------------------------
City | BRAZIL
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47834-0515
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-240-0939
-----------------------------------------------------
Fax | 812-446-2833
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | DR. JAMES FRANK FORSTER IV
-----------------------------------------------------
Credential | PSYD HSPP
-----------------------------------------------------
Telephone | 812-240-0939
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TA0700X
-----------------------------------------------------
Taxonomy Name | Adult Development & Aging Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------