Provider Demographics
NPI:1952831067
Name:FOSTER, PAUL (LICSW)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:FOSTER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:VT
Mailing Address - Zip Code:05055-9481
Mailing Address - Country:US
Mailing Address - Phone:802-649-8851
Mailing Address - Fax:
Practice Address - Street 1:108 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:VT
Practice Address - Zip Code:05055-9481
Practice Address - Country:US
Practice Address - Phone:802-649-8851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2020-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08901202701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical