Provider Demographics
NPI:1578660056
Name:FORSTER, MARGRIT (LCSW)
Entity type:Individual
Prefix:
First Name:MARGRIT
Middle Name:
Last Name:FORSTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARGRIT
Other - Middle Name:
Other - Last Name:FINLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1595 US HIGHWAY 70 E
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-8337
Mailing Address - Country:US
Mailing Address - Phone:731-571-7835
Mailing Address - Fax:
Practice Address - Street 1:1595 US HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-8337
Practice Address - Country:US
Practice Address - Phone:731-571-7835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000035681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3699621Medicaid
TN3699624Medicare ID - Type UnspecifiedPROVIDER #