Provider Demographics
NPI:1124484613
Name:FOSTER, KAY (LMSW)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 SE PEACHTREE DR
Mailing Address - Street 2:205
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-7216
Mailing Address - Country:US
Mailing Address - Phone:515-953-9256
Mailing Address - Fax:
Practice Address - Street 1:1609 N ANKENY BLVD
Practice Address - Street 2:STE 210
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4159
Practice Address - Country:US
Practice Address - Phone:515-953-9256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0773221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical