Provider Demographics
NPI:1598221343
Name:FOSTER, SYNECA
Entity Type:Individual
Prefix:
First Name:SYNECA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 N BICKETT BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2473
Mailing Address - Country:US
Mailing Address - Phone:919-637-2493
Mailing Address - Fax:919-729-0119
Practice Address - Street 1:216 N BICKETT BLVD STE 7
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2473
Practice Address - Country:US
Practice Address - Phone:919-637-2493
Practice Address - Fax:919-729-0119
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health