Provider Demographics
NPI:1336107267
Name:LOLETA WOOD FOSTER
Entity Type:Organization
Organization Name:LOLETA WOOD FOSTER
Other - Org Name:ASSESSMENT, COUNSELING & CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOLETA
Authorized Official - Middle Name:WOOD
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-864-5196
Mailing Address - Street 1:5114 YADKIN RD
Mailing Address - Street 2:#120
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-3251
Mailing Address - Country:US
Mailing Address - Phone:910-864-5196
Mailing Address - Fax:910-864-1092
Practice Address - Street 1:5114 YADKIN RD
Practice Address - Street 2:#120
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-3251
Practice Address - Country:US
Practice Address - Phone:910-864-5196
Practice Address - Fax:910-864-1092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1514103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2326591Medicare PIN