Provider Demographics
NPI:1386018646
Name:FOSTER, SARAH ALISA
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ALISA
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5925 GREENWELL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-1620
Mailing Address - Country:US
Mailing Address - Phone:225-926-7911
Mailing Address - Fax:225-926-7914
Practice Address - Street 1:5925 GREENWELL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1620
Practice Address - Country:US
Practice Address - Phone:225-926-7911
Practice Address - Fax:225-926-7914
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA600794486Medicaid