Provider Demographics
NPI:1184895294
Name:FOSTER, DANA BLANTON (LPC)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:BLANTON
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 RAY KENNEDY DR STE 240
Mailing Address - Street 2:P.O. BOX 487
Mailing Address - City:LOCUST
Mailing Address - State:NC
Mailing Address - Zip Code:28097-8000
Mailing Address - Country:US
Mailing Address - Phone:704-888-1616
Mailing Address - Fax:704-888-1670
Practice Address - Street 1:150 RAY KENNEDY DR
Practice Address - Street 2:SUITE 240
Practice Address - City:LOCUST
Practice Address - State:NC
Practice Address - Zip Code:28097-8000
Practice Address - Country:US
Practice Address - Phone:704-888-1616
Practice Address - Fax:704-888-1670
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2013-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6906101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional