Provider Demographics
NPI:1649365834
Name:FOSS, LOUISA L (PHD, NCC, LPC)
Entity type:Individual
Prefix:DR
First Name:LOUISA
Middle Name:L
Last Name:FOSS
Suffix:
Gender:F
Credentials:PHD, NCC, LPC
Other - Prefix:MS
Other - First Name:LOUISA
Other - Middle Name:L
Other - Last Name:FOSS-PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, LPCC
Mailing Address - Street 1:42 EAST HIGH STREET
Mailing Address - Street 2:SUITE 201, AVIA COUNSELING CENTER
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424
Mailing Address - Country:US
Mailing Address - Phone:860-267-2687
Mailing Address - Fax:860-267-2709
Practice Address - Street 1:42 EAST HIGH STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:EAST HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06424
Practice Address - Country:US
Practice Address - Phone:860-267-2687
Practice Address - Fax:860-267-2709
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001846101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional