Provider Demographics
NPI:1760979272
Name:FOSTER, SUSAN (PHD, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PHD, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48399 ALACK LN
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-3760
Mailing Address - Country:US
Mailing Address - Phone:985-662-4270
Mailing Address - Fax:
Practice Address - Street 1:607 E MORRIS AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-4353
Practice Address - Country:US
Practice Address - Phone:985-662-4270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4047101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional