Provider Demographics
NPI:1619366580
Name:FOSTER, ADRIENNE (LCSW)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 WALNUT GROVE DR
Mailing Address - Street 2:
Mailing Address - City:JARRATT
Mailing Address - State:VA
Mailing Address - Zip Code:23867-8611
Mailing Address - Country:US
Mailing Address - Phone:434-634-3217
Mailing Address - Fax:
Practice Address - Street 1:546 WALNUT GROVE DR
Practice Address - Street 2:
Practice Address - City:JARRATT
Practice Address - State:VA
Practice Address - Zip Code:23867-8611
Practice Address - Country:US
Practice Address - Phone:434-634-3217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040087921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical