Provider Demographics
NPI:1649448903
Name:FOSTER, DEBRA CORRINE (LCPC)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:CORRINE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LCPC
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 1054
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-1054
Mailing Address - Country:US
Mailing Address - Phone:301-659-4552
Mailing Address - Fax:
Practice Address - Street 1:401 CARROLL ST
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-5986
Practice Address - Country:US
Practice Address - Phone:301-659-4552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2661101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional