Provider Demographics
NPI:1982743548
Name:FOSTER, JOEL TIMOTHY (PHD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:TIMOTHY
Last Name:FOSTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 LANGLEY ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-5247
Mailing Address - Country:US
Mailing Address - Phone:719-359-2870
Mailing Address - Fax:
Practice Address - Street 1:21ST MDG
Practice Address - Street 2:559 VINCENT STREET
Practice Address - City:PAFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-556-5898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1392103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist