Shannon Foster, L.C.S.W.

Individual provider Active NPI Clinical Social Worker · West Milford, NJ

NPI 1669524591 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1669524591
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC05245900 (NJ)
Practice address
179 Cahill Cross Rd
Suite 212
West Milford, NJ 07480-1988
Phone
(973) 248-5896
Fax
(973) 208-3344
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05245900 NJ Yes

Addresses

Primary practice location

179 Cahill Cross Rd
Suite 212
West Milford, NJ 07480-1988

Mailing address

25 Hightop Rd
West Milford, NJ 07480-4112
Phone (973) 409-4368

Other identifiers

IdentifierTypeStateIssuer
P3613030OtherNJOXFORD HEALTH PLANS

Other providers in West Milford, NJ

All providers in West Milford, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.