MEDICARE: MR. BRANDON LEE FOSTER LCSW

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	1041C0700X	Clinical Social Worker	0904018896	VA

General Provider Information

NPI Number	:	1982565115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRANDON LEE FOSTER LCSW

Provider Business Mailing Address
First Line	:	5817 WESLEYAN DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-4637
Country	:	US
Telephone Number	:	757-455-5730
Fax Number	:

Provider Business Practice Location Address
First Line	:	5817 WESLEYAN DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-4637
Country	:	US
Telephone Number	:	757-455-5730
Fax Number	:

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

Provider Enumeration Date	:	11/18/2025
Last Update Date	:	11/18/2025

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