Provider Demographics
NPI:1932678026
Name:FOSTER, CHRISTABEL EDEN (LSW)
Entity Type:Individual
Prefix:
First Name:CHRISTABEL
Middle Name:EDEN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:CHRISTABEL
Other - Middle Name:EDEN
Other - Last Name:VAN DER VEKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:285 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3005
Mailing Address - Country:US
Mailing Address - Phone:908-707-0212
Mailing Address - Fax:908-707-8498
Practice Address - Street 1:285 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-3005
Practice Address - Country:US
Practice Address - Phone:908-707-0212
Practice Address - Fax:908-707-8498
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL061884001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical