Healthcare Provider Details

I. General information

NPI: 1275990400
Provider Name (Legal Business Name): H'JORDIS FOSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2016
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2924 KNIGHT ST STE 426
SHREVEPORT LA
71105-2414
US

IV. Provider business mailing address

4709 MCDANIEL DR
SHREVEPORT LA
71109-6601
US

V. Phone/Fax

Practice location:
  • Phone: 318-754-3560
  • Fax: 318-779-0439
Mailing address:
  • Phone: 318-469-5796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLPC10578
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: