Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dominique Forsman

Individual provider Counselor · NPI 1972321180

Dominique Forsman is a Counselor in Churchton, Maryland. Practices as a sole proprietor. Licensed in Maryland.

Licensed in
MD
In the registry since
2024
Specialties on file
2

Practice location Address checks out

5419 Deale Churchton Rd Ste 104
Churchton, MD 20733-2408
Phone: (410) 541-6686
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LGP15666 (MD)
Counselor Taxonomy 101Y00000X · Licence LGP15666 (MD)

Record details

NPI number1972321180
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 27, 2024
Last updated in NPPESSeptember 27, 2024
Certification dateSeptember 27, 2024

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