Provider Demographics
NPI:1083789416
Name:FOSTER, CHARLESETTE W (MA)
Entity Type:Individual
Prefix:MRS
First Name:CHARLESETTE
Middle Name:W
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15TH AND U STREETS
Mailing Address - Street 2:213 UNIVERSITY HEALTH CENTER
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68588-0618
Mailing Address - Country:US
Mailing Address - Phone:402-472-7450
Mailing Address - Fax:402-472-8010
Practice Address - Street 1:15TH AND U STREETS
Practice Address - Street 2:213 UNIVERSITY HEALTH CENTER
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68588-0618
Practice Address - Country:US
Practice Address - Phone:402-472-7450
Practice Address - Fax:402-472-8010
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2827101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health