Healthcare Provider Details

I. General information

NPI: 1578125654
Provider Name (Legal Business Name): ALLYSON FOSTER LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 W PINE ST STE 4
MISSOULA MT
59802-4222
US

IV. Provider business mailing address

114 W PINE ST STE 4
MISSOULA MT
59802-4222
US

V. Phone/Fax

Practice location:
  • Phone: 406-532-9770
  • Fax: 406-541-3034
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number38233
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: