Provider Demographics
NPI:1437499951
Name:FOSTER, LONNIE JERMAINE JR (MA, CTM, MCAP)
Entity Type:Individual
Prefix:MR
First Name:LONNIE
Middle Name:JERMAINE
Last Name:FOSTER
Suffix:JR
Gender:M
Credentials:MA, CTM, MCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5694 CENTURY 21 BLVD
Mailing Address - Street 2:APARTMENT #11
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-2295
Mailing Address - Country:US
Mailing Address - Phone:407-757-9327
Mailing Address - Fax:
Practice Address - Street 1:5694 CENTURY 21 BLVD
Practice Address - Street 2:APARTMENT #11
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-2295
Practice Address - Country:US
Practice Address - Phone:407-757-9327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL171M00000OtherCASE MANAGER / CARE COORDINATOLR