Provider Demographics
NPI:1700095502
Name:FOSTER, EVELYN WHITNEY (MSW)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:WHITNEY
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 PIONEER FARM WAY
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-3853
Mailing Address - Country:US
Mailing Address - Phone:207-667-1800
Mailing Address - Fax:
Practice Address - Street 1:173 PIONEER FARM WAY
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-3853
Practice Address - Country:US
Practice Address - Phone:207-667-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC8073104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker