Provider Demographics
NPI:1740200112
Name:FOSTER, LOUISA WENZEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LOUISA
Middle Name:WENZEL
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4915 UNDERWOOD AVE
Mailing Address - Street 2:#2
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-4211
Mailing Address - Country:US
Mailing Address - Phone:402-933-4070
Mailing Address - Fax:
Practice Address - Street 1:4915 UNDERWOOD AVE
Practice Address - Street 2:#2
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-4211
Practice Address - Country:US
Practice Address - Phone:402-933-4070
Practice Address - Fax:402-932-4641
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE572103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE35688OtherMIDLANDS CHOICE
NE08128OtherBCBS
NE10024962900Medicaid
NE348839000OtherMAGELLAN
NE35688OtherMIDLANDS CHOICE
NE10024962900Medicaid