Provider Demographics
NPI:1306098512
Name:FOERSTER, MARY LOUISE (LPC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:LOUISE
Last Name:FOERSTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S CONGRESS AVE APT 333
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-1711
Mailing Address - Country:US
Mailing Address - Phone:512-619-0333
Mailing Address - Fax:
Practice Address - Street 1:500 S CONGRESS AVE APT 333
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-1711
Practice Address - Country:US
Practice Address - Phone:512-619-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61407101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX61407OtherLPC