Provider Demographics
NPI:1659057297
Name:FOSTER, KELSIE ALISE (LPC, ATR-P)
Entity Type:Individual
Prefix:
First Name:KELSIE
Middle Name:ALISE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LPC, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1024
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-1024
Mailing Address - Country:US
Mailing Address - Phone:607-742-0480
Mailing Address - Fax:
Practice Address - Street 1:323 1/2 EVANS ST
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:CO
Practice Address - Zip Code:80540-5039
Practice Address - Country:US
Practice Address - Phone:607-742-0480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty