Mr. Vernon Wayne Forman
CERTIFICATIONS | Addiction (Substance Use Disorder) Counselor
722 S Spring St, Port Washington
Wisconsin, 53074-2334
262-483-0048 Maps & DirectionsMr. Vernon Wayne Forman is a Port Washington, Wisconsin based counselor who is specialized as Addiction (Substance Use Disorder) Counselor. Active license number of Mr. Vernon Wayne Forman is 1701 for Addiction (Substance Use Disorder) Counselor in Wisconsin. His current practice location is 722 S Spring St, Port Washington. Patients can book an appointment with him at 262-483-0048.
Mr. Vernon Wayne Forman is a licensed mental health therapist who help individuals struggling with addiction of alcohol, drug, or other substance use disorder. He helps his clients by manage and overcome the psychological, emotional, and behavioral challenges related to substance use. Counselors also work closely with families and support systems to help them better understand their loved one’s illness. SUD counselors help to promote long-term sobriety, emotional stability, and overall mental wellness for both the individual and their family.
Complete Profile:
Mr. Vernon Wayne Forman speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Mr. Vernon Wayne Forman |
| Specialization: | Addiction (Substance Use Disorder) Counselor |
| Gender: | Male |
| Credentials: | CERTIFICATIONS |
| Accepts Medicare Assignment: | No |
| Practice Address: | 722 S Spring St, Port Washington,
Wisconsin, 53074-2334 |
| Phone: | 262-483-0048 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1952403966 |
| NPI Enumeration Date: | 01 Sep, 2006 |
| NPI Last Update On: | 08 Jul, 2007 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Vernon Wayne Forman are as mentioned below.
| License Number | Specialization | State | Status | |
| 1701 | Addiction (Substance Use Disorder) Counselor | Wisconsin | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Mr. Vernon Wayne Forman such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1701 | Other | Wisconsin | CERT. AODA COUNSELOR III |
| 11482 | Other | Wisconsin | CERT. CLIN. SUPERVISOR II |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 722 S Spring St,
Port Washington, Wisconsin |
| Zip: | 53074-2334 |
| Phone Number: | 262-483-0048 |
Patients can reach Mr. Vernon Wayne Forman at
722 S Spring St, Port Washington, Wisconsin or can
call to book an appointment on 262-483-0048.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.