Provider Demographics
NPI:1558501825
Name:FOSTER, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:MCCRACKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6325 WOODSIDE CT STE 350
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1042
Mailing Address - Country:US
Mailing Address - Phone:410-910-9660
Mailing Address - Fax:
Practice Address - Street 1:12501 PROSPERITY DR STE 310
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1699
Practice Address - Country:US
Practice Address - Phone:410-910-9660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1952589228OtherCARES CRISIS RESIDENTIAL NORTH
CA1689762486OtherTELECARE CARES CRISIS RESIDENTIAL