Provider Demographics
NPI:1679996003
Name:FOSTER, CASONDRA MARIE (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:CASONDRA
Middle Name:MARIE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134-2373
Mailing Address - Country:US
Mailing Address - Phone:816-547-7119
Mailing Address - Fax:
Practice Address - Street 1:9725 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134-2373
Practice Address - Country:US
Practice Address - Phone:816-547-7119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013007077101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional