Individual provider Active NPI

Roberta Foster, CDCA OCPSA

  • Prevention Professional
  • Lorain, OH
National Provider Identifier
1407462609
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prevention ProfessionalTaxonomy code 405300000X
License
4097 Issued in OH
Practice address
2314 Kelly PL
Lorain, OH 44052-4838
Phone
(440) 246-4616
Fax
(440) 246-1997
NPI assigned
Sep 22, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prevention Professional 405300000X 4097 OH Primary

Addresses

Primary practice location

2314 Kelly PL
Lorain, OH 44052-4838

Mailing address

2314 Kelly PL
Lorain, OH 44052-4838
Phone (440) 246-4616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4097OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lorain Urban Minority Alcoholism and Drug Abuse Outreach Program CurrentSince Sep 27, 2020 Accepting new patients

Locations

2314 Kelly Pl
Lorain, OH 44052
Phone (440) 246-4616

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1407462609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 KELLY PL",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440524838",
            "telephone_number": "440-246-4616",
            "fax_number": "440-246-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 KELLY PL",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440524838",
            "telephone_number": "440-246-4616",
            "fax_number": "440-246-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "ROBERTA",
        "credential": "CDCA OCPSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "OH",
            "license": "4097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.