Provider Demographics
NPI:1407628746
Name:FOSTER, KELSIE NICHELLE (PHD CRC)
Entity Type:Individual
Prefix:DR
First Name:KELSIE
Middle Name:NICHELLE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PHD CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MULBERRY DR UNIT 3-103
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4588
Mailing Address - Country:US
Mailing Address - Phone:732-857-6553
Mailing Address - Fax:
Practice Address - Street 1:5600 POST RD STE 114-193
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3400
Practice Address - Country:US
Practice Address - Phone:732-443-0385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS02089103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling