Organization
FOSTERING CHANGE COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS JUSTAVIS FOSTER (CEO)
(706) 447-9722
Entity
Organization
Contact information
Practice address
2826 HILLCREEK DR, AUGUSTA, GA 30909-5628
(706) 447-9722
Mailing address
3031 BROCKHAM CT, AUGUSTA, GA 30909-0629
(706) 945-9731
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/06/2017
Last updated
01/18/2024
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