Provider Demographics
NPI:1417033275
Name:FOSTER, LAURA KATHLEEN (MED, LPC-S, RPT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHLEEN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MED, LPC-S, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2499 S CAPITAL OF TEXAS HWY
Mailing Address - Street 2:SUITE B-201
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7758
Mailing Address - Country:US
Mailing Address - Phone:512-468-8025
Mailing Address - Fax:512-328-3034
Practice Address - Street 1:2499 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:SUITE B-201
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7758
Practice Address - Country:US
Practice Address - Phone:512-468-8025
Practice Address - Fax:512-328-3034
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15446101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0960726-03Medicaid
TX352197000Medicare UPIN
TX0960726-03Medicaid
TX7974440Medicare UPIN