Provider Demographics
NPI:1386830909
Name:FOSTER, LAURA E (MA, ATR-BC, LCPC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:E
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MA, ATR-BC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 W BLOOMINGDALE AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5364
Mailing Address - Country:US
Mailing Address - Phone:773-576-7032
Mailing Address - Fax:773-486-1345
Practice Address - Street 1:2318 W BLOOMINGDALE AVE
Practice Address - Street 2:UNIT B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5364
Practice Address - Country:US
Practice Address - Phone:773-576-7032
Practice Address - Fax:773-486-1345
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007233101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional