Provider Demographics
NPI:1942591623
Name:FOSTER, BILLY CLAY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:CLAY
Last Name:FOSTER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6206 CYPRESS POINT DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-3208
Mailing Address - Country:US
Mailing Address - Phone:318-345-2855
Mailing Address - Fax:
Practice Address - Street 1:6206 CYPRESS POINT DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-3208
Practice Address - Country:US
Practice Address - Phone:318-345-2855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2019-08-26
Deactivation Date:2011-05-12
Deactivation Code:
Reactivation Date:2019-08-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1245448992Medicaid
LA1083821417Medicaid
LA1184863380Medicaid
LA1669690962Medicaid
LA1548498629Medicaid
LA1326282856Medicaid