Provider Demographics
NPI:1659896116
Name:FOUST, CRAIG (PLPC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:FOUST
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 MIRANDY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5451
Mailing Address - Country:US
Mailing Address - Phone:636-278-0552
Mailing Address - Fax:
Practice Address - Street 1:2211 S BRENTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:MO
Practice Address - Zip Code:63144-1803
Practice Address - Country:US
Practice Address - Phone:636-278-0552
Practice Address - Fax:636-278-0552
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015040220101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional