Provider Demographics
NPI:1326530890
Name:FOSTER, RYAN LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:LYNN
Last Name:FOSTER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15512 MISS ADRIENNES PATH
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3282
Mailing Address - Country:US
Mailing Address - Phone:940-736-8859
Mailing Address - Fax:
Practice Address - Street 1:600 ROUND ROCK DR W STE 403
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5005
Practice Address - Country:US
Practice Address - Phone:940-736-8859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73598101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor