Provider Demographics
NPI:1942719034
Name:FOSTER, KATHRYNE ELIZABETH (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:KATHRYNE
Middle Name:ELIZABETH
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 LE PHILLIP CT NE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2900
Mailing Address - Country:US
Mailing Address - Phone:704-721-5551
Mailing Address - Fax:704-721-5579
Practice Address - Street 1:219 LE PHILLIP CT NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2900
Practice Address - Country:US
Practice Address - Phone:704-721-5551
Practice Address - Fax:704-721-5579
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0119011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical