MEDICARE: INTERFACE PSYCHOLOGICAL SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	831271513501	UT

General Provider Information

NPI Number	:	1548338833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERFACE PSYCHOLOGICAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	508 E SOUTH TEMPLE STE 201
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1099
Country	:	US
Telephone Number	:	801-328-8817
Fax Number	:	801-366-4284

Provider Business Practice Location Address
First Line	:	508 E SOUTH TEMPLE STE 201
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1099
Country	:	US
Telephone Number	:	801-328-8817
Fax Number	:	801-366-4284

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THOMAS MAX FOSTER
Credential	:	LCSW
Telephone Number	:	801-328-8817

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1649268202 — ERNESTO ZAVALETA, MD, PA
Practice Location Address:

1099 CITRUS TOWER BLVD , SOUTH LAKE HOSPITAL
CLERMONT, FL
34711

Practice Phone: 352-241-9322
Practice Fax: 352-241-9107

1164403267 — DR. JOHN WILLIAM CRETZMEYER JR. DDS
Practice Location Address:

1099 MOORE LAKE DR E
FRIDLEY, MN
55432-5153

Practice Phone: 763-586-9988
Practice Fax: 763-586-9977

1497739049 — MUNISHA MEHRA BHATIA MD
Practice Location Address:

1500 W KENNEDY RD
LAKE FOREST, IL
60045-1099

Practice Phone: 312-933-6979
Practice Fax:

1518048453 — CYNTHIA GHERMAN MD
Practice Location Address:

18599 LAKE SHORE BLVD STE 100
EUCLID, OH
44119-1099

Practice Phone: 216-383-7800
Practice Fax: 216-383-5376

1639238892 — CURTIS DEAN WEYRAUCH DDS
Practice Location Address:

1099 EAST MOORE LAKE DRIVE
FRIDLEY, MN
55432

Practice Phone: 763-586-9988
Practice Fax: 763-586-9977

1841351582 — ROBERT LONNIE LAING DDS
Practice Location Address:

1099 EAST MOORE LAKE DRIVE
FRIDLEY, MN
55432

Practice Phone: 763-586-9988
Practice Fax: 763-586-9977

Directions to “INTERFACE PSYCHOLOGICAL SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.