Provider Demographics
NPI:1306347620
Name:FOSTER, ELIZABETH D (LICSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:D
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:PO BOX 1801
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-1801
Mailing Address - Country:US
Mailing Address - Phone:603-931-3204
Mailing Address - Fax:
Practice Address - Street 1:633 MAPLE STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:CONTOOCOOK
Practice Address - State:NH
Practice Address - Zip Code:03229
Practice Address - Country:US
Practice Address - Phone:603-931-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-22
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical