Provider Demographics
NPI:1528159035
Name:FOSTER, MARY M (MA LPC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:M
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 745066
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80006-5066
Mailing Address - Country:US
Mailing Address - Phone:303-947-6847
Mailing Address - Fax:303-940-6285
Practice Address - Street 1:1499 W 120TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2719
Practice Address - Country:US
Practice Address - Phone:303-947-6847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional