Healthcare Provider Details

I. General information

NPI: 1720886740
Provider Name (Legal Business Name): MICHELLE FOSTER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 E PINE ST
SILVER CITY NM
88061-7155
US

IV. Provider business mailing address

PO BOX 325
SILVER CITY NM
88062-0325
US

V. Phone/Fax

Practice location:
  • Phone: 575-590-6197
  • Fax: 575-590-6079
Mailing address:
  • Phone: 575-956-6131
  • Fax: 575-956-6947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2025-0183
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: