Provider Demographics
NPI:1235582412
Name:FOSTER, LISA MARIE (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:LUBLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:427 W DUSSEL DR
Mailing Address - Street 2:#205
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-4208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1446 REYNOLDS RD
Practice Address - Street 2:SUITE #313
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1684
Practice Address - Country:US
Practice Address - Phone:419-720-5800
Practice Address - Fax:419-720-4444
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1300244101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional