MEDICARE: JOAN A. FOSTER LISW, LICDC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	965799	OH
2	1041C0700X	Clinical Social Worker	I. 0004831	OH

General Provider Information

NPI Number	:	1730117847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN A. FOSTER LISW, LICDC

Provider Business Mailing Address
First Line	:	3461 WARRENSVILLE CENTER RD
Second Line	:	SUITE 304
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44122-5227
Country	:	US
Telephone Number	:	216-751-4763
Fax Number	:	216-751-4599

Provider Business Practice Location Address
First Line	:	3461 WARRENSVILLE CENTER RD
Second Line	:	SUITE 304
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44122-5227
Country	:	US
Telephone Number	:	216-751-4763
Fax Number	:	216-751-4599

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	09/11/2025

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