MEDICARE: JOANN FOSTER MA LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LLP 6401006489	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LLP 6401006489	OTHER	MI	JOANN FOSTER MA LPC

General Provider Information

NPI Number	:	1417074816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN FOSTER MA LPC

Provider Business Mailing Address
First Line	:	6019 WESTSIDE SAGINAW RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9357
Country	:	US
Telephone Number	:	989-686-7650
Fax Number	:	989-686-7688

Provider Business Practice Location Address
First Line	:	6019 WESTSIDE SAGINAW RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9357
Country	:	US
Telephone Number	:	989-686-7650
Fax Number	:	989-686-7688

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/08/2007

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Directions to “ JOANN FOSTER MA LPC” Practice Location

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