Provider Demographics
NPI:1083602460
Name:FOSTER, MARYANN (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:MARYANN
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 540
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-0540
Mailing Address - Country:US
Mailing Address - Phone:301-929-0262
Mailing Address - Fax:202-363-4891
Practice Address - Street 1:6140 31ST ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-1516
Practice Address - Country:US
Practice Address - Phone:202-363-4891
Practice Address - Fax:202-363-4891
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FOSIS385Medicare ID - Type Unspecified