Provider Demographics
NPI:1275697906
Name:FOSTER, AMY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 W 96TH ST
Mailing Address - Street 2:6F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6607
Mailing Address - Country:US
Mailing Address - Phone:917-319-7954
Mailing Address - Fax:212-662-2568
Practice Address - Street 1:27 W 96TH ST
Practice Address - Street 2:6F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6607
Practice Address - Country:US
Practice Address - Phone:917-319-7954
Practice Address - Fax:212-662-2568
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR040340-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical