Provider Demographics
NPI:1528261948
Name:FOUST, MICHAEL A (LCSW)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:FOUST
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689 MYRTLE ST NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-8300
Mailing Address - Country:US
Mailing Address - Phone:404-274-1027
Mailing Address - Fax:
Practice Address - Street 1:689 MYRTLE ST NE
Practice Address - Street 2:SUITE C
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-8300
Practice Address - Country:US
Practice Address - Phone:404-274-1027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0033211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical