Provider Demographics
NPI:1194903005
Name:FOSTER, TAMMY LYNN (LCPC)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LYNN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 ROOSEVELT RD
Mailing Address - Street 2:BLDG A STE 321
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137
Mailing Address - Country:US
Mailing Address - Phone:630-674-6878
Mailing Address - Fax:630-830-9712
Practice Address - Street 1:800 ROOSEVELT RD
Practice Address - Street 2:BLDG A STE 321
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137
Practice Address - Country:US
Practice Address - Phone:630-674-6878
Practice Address - Fax:630-830-9712
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health