Provider Demographics
NPI:1972188498
Name:FOSTER, JASMEKA KOASHER (MS, NCC, PCMHT)
Entity Type:Individual
Prefix:
First Name:JASMEKA
Middle Name:KOASHER
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MS, NCC, PCMHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 LYLES DR
Mailing Address - Street 2:
Mailing Address - City:SHANNON
Mailing Address - State:MS
Mailing Address - Zip Code:38868-8333
Mailing Address - Country:US
Mailing Address - Phone:662-321-1861
Mailing Address - Fax:
Practice Address - Street 1:103 SOUTHLAKE CIR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-5369
Practice Address - Country:US
Practice Address - Phone:601-859-8371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor