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

Individual provider Clinical Neuropsychologist · NPI 1942909817

Nicole M Fornalski, PSYD is a Clinical Psychologist in Columbus, Ohio. Qualified in 2021, 5 years ago. Practices with Osu Physical Medicine and Rehabilitation LLC, a 35-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
5
Licensed in
OH
In the registry since
2023
Specialties on file
2
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

480 Medical Center Dr
Columbus, OH 43210-1229
Phone: (614) 293-7604
Fax: (614) 293-3809
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence P.08416 (OH)
Rehabilitation Psychologist Taxonomy 103TR0400X · Licence P.08416 (OH)

Record details

NPI number1942909817
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorNo
NPI enumeratedFebruary 28, 2023
Last updated in NPPESMay 16, 2023
Certification dateMay 16, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Osu Physical Medicine And Rehabilitation Llc — 35 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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