Healthcare Provider Details

I. General information

NPI: 1336304880
Provider Name (Legal Business Name): ROBERT ALLEN FOSTER LPC, LCAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5209 W WENDOVER AVE
HIGH POINT NC
27265-9177
US

IV. Provider business mailing address

210 BUTNER RD
TOBACCOVILLE NC
27050-9101
US

V. Phone/Fax

Practice location:
  • Phone: 336-845-4006
  • Fax:
Mailing address:
  • Phone: 336-983-6686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number45
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2868
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: