Provider Demographics
NPI:1700930369
Name:FOSTER, NANCY C (LICSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HAZELBROOK LN
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-1501
Mailing Address - Country:US
Mailing Address - Phone:508-358-4657
Mailing Address - Fax:
Practice Address - Street 1:17 HAZELBROOK LN
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-1501
Practice Address - Country:US
Practice Address - Phone:508-358-4657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1011261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical