MEDICARE: MARY ALYSIA FOSTER M.ED, LPCC

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	101YP2500X	Professional Counselor	299841	KY
2	101YM0800X	Mental Health Counselor	299841	KY

General Provider Information

NPI Number	:	1629967369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ALYSIA FOSTER M.ED, LPCC

Provider Business Mailing Address
First Line	:	244 W IRVINE ST
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-1438
Country	:	US
Telephone Number	:	502-783-7573
Fax Number	:	844-822-8194

Provider Business Practice Location Address
First Line	:	244 W IRVINE ST
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-1438
Country	:	US
Telephone Number	:	502-783-7573
Fax Number	:	844-822-8194

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

Provider Enumeration Date	:	06/30/2025
Last Update Date	:	06/30/2025

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