MEDICARE: MRS. PAMELA H FORSEY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	1041C0700X	Clinical Social Worker	34003949A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000212216	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1972629327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAMELA H FORSEY LCSW

Provider Business Mailing Address
First Line	:	52305 OAK RUN DR
Second Line	:
City	:	GRANGER
State	:	IN
Zip	:	46530-7411
Country	:	US
Telephone Number	:	574-233-4183
Fax Number	:	574-273-1229

Provider Business Practice Location Address
First Line	:	2319 EDISON RD
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46615-3515
Country	:	US
Telephone Number	:	574-233-4183
Fax Number	:	574-273-1229

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	09/11/2025

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