Provider Demographics
NPI:1770347775
Name:FOSTER YOUR MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:FOSTER YOUR MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCMH
Authorized Official - Phone:724-484-3606
Mailing Address - Street 1:12711 DUPONT BLVD
Mailing Address - Street 2:
Mailing Address - City:ELLENDALE
Mailing Address - State:DE
Mailing Address - Zip Code:19941-3306
Mailing Address - Country:US
Mailing Address - Phone:724-484-3606
Mailing Address - Fax:
Practice Address - Street 1:117 MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-8410
Practice Address - Country:US
Practice Address - Phone:724-484-3606
Practice Address - Fax:302-297-1770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty