Healthcare Provider Details

I. General information

NPI: 1659759769
Provider Name (Legal Business Name): SHALICE FOSTER LCSW, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 S CENTER ST
ORANGE NJ
07050-3205
US

IV. Provider business mailing address

1515 ROUTE 22 WEST STE 30 # 1046
WATCHUNG NJ
07069
US

V. Phone/Fax

Practice location:
  • Phone: 973-675-3817
  • Fax:
Mailing address:
  • Phone: 203-666-1792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05796200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00255800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: