Provider Demographics
NPI:1841563525
Name:WARDLAW, FOSTER BRADLEY III (PHD, LRT/CTRS)
Entity Type:Individual
Prefix:DR
First Name:FOSTER
Middle Name:BRADLEY
Last Name:WARDLAW
Suffix:III
Gender:M
Credentials:PHD, LRT/CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GOVERNMENT AVE SW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-2936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 GOVERNMENT AVE SW
Practice Address - Street 2:SUITE 300
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-2936
Practice Address - Country:US
Practice Address - Phone:828-315-7707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-11
Last Update Date:2012-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health