Provider Demographics
NPI:1558155952
Name:FOSTER-WEXLER, AMY R (LCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:FOSTER-WEXLER
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:R
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:62950 FRESCA ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-1581
Mailing Address - Country:US
Mailing Address - Phone:541-280-3766
Mailing Address - Fax:
Practice Address - Street 1:62950 FRESCA ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-1581
Practice Address - Country:US
Practice Address - Phone:541-280-3766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL47331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical