Provider Demographics
NPI:1902569668
Name:CARLEY A FOSTER
Entity type:Organization
Organization Name:CARLEY A FOSTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-436-2508
Mailing Address - Street 1:7926 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-4218
Mailing Address - Country:US
Mailing Address - Phone:828-989-9176
Mailing Address - Fax:
Practice Address - Street 1:7926 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-4218
Practice Address - Country:US
Practice Address - Phone:828-989-9176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health