Provider Demographics
NPI:1548792773
Name:FOSTER-MARTIN, GABRIELA (LMSW, CSW-INTERN)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:FOSTER-MARTIN
Suffix:
Gender:F
Credentials:LMSW, CSW-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6629 TUMBLEWEED RIDGE LN UNIT 103
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-1465
Mailing Address - Country:US
Mailing Address - Phone:702-530-1432
Mailing Address - Fax:
Practice Address - Street 1:6629 TUMBLEWEED RIDGE LN UNIT 103
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-1465
Practice Address - Country:US
Practice Address - Phone:702-530-1432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV89115171M00000X
NVIC-25161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator