Healthcare Provider Details

I. General information

NPI: 1770382079
Provider Name (Legal Business Name): SARAH E FOSTER LMLP-T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 E 22ND ST N STE 100
WICHITA KS
67226-2350
US

IV. Provider business mailing address

709 WAVERLY ST
WICHITA KS
67218-2718
US

V. Phone/Fax

Practice location:
  • Phone: 316-201-6047
  • Fax:
Mailing address:
  • Phone: 316-249-7641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLMLP-03408
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberLMLP-03408
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLMLP-03408
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLMLP-03408
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberLMLP-03408
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberLMLP-03408
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: