Provider Demographics
NPI:1609971894
Name:FOSTER, JODIE LYNN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:JODIE
Middle Name:LYNN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 BUCKINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-4569
Mailing Address - Country:US
Mailing Address - Phone:443-536-7340
Mailing Address - Fax:
Practice Address - Street 1:5420 KLEE MILL RD S
Practice Address - Street 2:SUITE 6
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-9230
Practice Address - Country:US
Practice Address - Phone:443-536-7340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2166101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT541-0070OtherBCBS-DC
MD8843-0001OtherBCBS-DC
MD261374OtherKAISER
7614895OtherAETNA
MD88752602OtherCAREFIRST BCBS
MD88752601OtherCAREFIRST BCBS
MD276156OtherCOMPSYCH