Provider Demographics
NPI:1326017344
Name:FOSTER, DEBORAH (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
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 1:303 CHURCH ST
Mailing Address - Street 2:REAR BUILDING UNIT 2
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2468
Mailing Address - Country:US
Mailing Address - Phone:203-458-1117
Mailing Address - Fax:866-544-3118
Practice Address - Street 1:303 CHURCH ST
Practice Address - Street 2:REAR BUILDING UNIT 2
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2468
Practice Address - Country:US
Practice Address - Phone:203-458-1117
Practice Address - Fax:866-544-3118
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0054361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00466032OtherRAILROAD MEDICARE
CT004261244Medicaid
P00466032OtherRAILROAD MEDICARE