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

Dr. Eli Michael Simong Forman, PHD

Individual provider Mental Health Counselor · NPI 1033218714

Dr. Eli Michael Simong Forman, PHD is a Mental Health Counselor in Leonia, New Jersey. Licensed in California, Maryland, New Jersey and New York. Registered with an NPI since 2006.

Licensed in
CA, MD, NJ, NY
In the registry since
2006
Specialties on file
5
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

431 Park Ave
Leonia, NJ 07605-1219
Phone: (201) 592-7388
Fax: (201) 592-6301
Show map & directions

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

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 37F100059900 (NJ)
Mental Health Counselor Taxonomy 101YM0800X · Licence 5688633 (NY)
Professional Counselor Taxonomy 101YP2500X · Licence 0019 (MD)
Marriage & Family Therapist Taxonomy 106H00000X · Licence M038 (MD)
Marriage & Family Therapist Taxonomy 106H00000X · Licence MFC13681 (CA)

Record details

NPI number1033218714
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedSeptember 21, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address431 Park Avenue, Leonia, NJ 07605-1219

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