Provider Demographics
NPI:1770835746
Name:FOSTER, MARY CASSANDRA (LCSW-R)
Entity type:Individual
Prefix:
First Name:MARY CASSANDRA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:M. CASSANDRA
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:26 BELDEN AVE UNIT 1405
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3368
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26 BELDEN AVE UNIT 1405
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3368
Practice Address - Country:US
Practice Address - Phone:718-877-6505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0525241041C0700X
CT130221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical