MEDICARE: CARLOS FOSTER LCSW

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	1041C0700X	Clinical Social Worker	11381	SC
2	1041C0700X	Clinical Social Worker	CSW006880	GA

General Provider Information

NPI Number	:	1518339878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS FOSTER LCSW

Provider Business Mailing Address
First Line	:	2826 HILLCREEK DR
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-5628
Country	:	US
Telephone Number	:	706-945-6360
Fax Number	:

Provider Business Practice Location Address
First Line	:	2826 HILLCREEK DR
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-5628
Country	:	US
Telephone Number	:	706-447-9722
Fax Number	:

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

Provider Enumeration Date	:	10/27/2015
Last Update Date	:	01/18/2024

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