| Mary Ann Forster, Lcsw, Llc | |
|
101 Park St Suite 1 Montclair NJ 07042-2963 | |
| (201) 503-4943 | |
| Not Available |
| Full Name | Mary Ann Forster, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 101 Park St, Montclair, New Jersey |
| Authorized Official Name and Position | Mary Ann Forster (OWNER) |
| Authorized Official Contact | 2015034943 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Ann Forster, Lcsw, Llc 111 Arnot Pl Wood Ridge NJ 07075-1426 Ph: (201) 503-4943 | Mary Ann Forster, Lcsw, Llc 101 Park St Suite 1 Montclair NJ 07042-2963 Ph: (201) 503-4943 |
| NPI Number | 1689021818 |
|---|---|
| Provider Enumeration Date | 05/17/2016 |
| Last Update Date | 05/17/2016 |
| Medicare PECOS PAC ID | 0840582631 |
|---|---|
| Medicare Enrollment ID | O20160715000070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689021818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SC043365 (New Jersey) | Primary |
| Provider Name | Mary Ann Forster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013078658 PECOS PAC ID: 3779472485 Enrollment ID: I20040311000993 |
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