Healthcare Provider Details

I. General information

NPI: 1720998313
Provider Name (Legal Business Name): MS. STEPHANIE ELIN FOSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 LINCOLN AVE
FENNIMORE WI
53809-1746
US

IV. Provider business mailing address

231 W OAK ST
LANCASTER WI
53813-1646
US

V. Phone/Fax

Practice location:
  • Phone: 608-822-5052
  • Fax:
Mailing address:
  • Phone: 608-723-9531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9309-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: