Provider Demographics
NPI:1245380690
Name:FOSS, CHARLENE B (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHARLENE
Middle Name:B
Last Name:FOSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18 SUNSHINE AVE
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1907
Mailing Address - Country:US
Mailing Address - Phone:508-655-4905
Mailing Address - Fax:508-620-2072
Practice Address - Street 1:300 HOWARD ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8313
Practice Address - Country:US
Practice Address - Phone:508-620-2484
Practice Address - Fax:508-620-2472
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2135451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical