Provider Demographics
NPI:1629854070
Name:FOSTINO, ERIK JAMES (MSW)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:JAMES
Last Name:FOSTINO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 S ALMA SCHOOL RD STE 130
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3088
Mailing Address - Country:US
Mailing Address - Phone:480-902-0771
Mailing Address - Fax:
Practice Address - Street 1:15136 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-6909
Practice Address - Country:US
Practice Address - Phone:217-853-7451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional