Provider Demographics
NPI:1881150241
Name:CHAD FOSTER COUNSELING, LLC
Entity type:Organization
Organization Name:CHAD FOSTER COUNSELING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:270-929-0162
Mailing Address - Street 1:4323 PLANTATION PT
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-7808
Mailing Address - Country:US
Mailing Address - Phone:270-313-8128
Mailing Address - Fax:
Practice Address - Street 1:100 W 3RD ST STE 207
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4135
Practice Address - Country:US
Practice Address - Phone:270-929-0162
Practice Address - Fax:270-228-0341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty