Provider Demographics
NPI:1144190133
Name:BOBBI FOSBURG PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:BOBBI FOSBURG PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:BOBBI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:FOSBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-640-3420
Mailing Address - Street 1:5944 MARKET ST APT H
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-7979
Mailing Address - Country:US
Mailing Address - Phone:435-640-3420
Mailing Address - Fax:
Practice Address - Street 1:3070 RASMUSSEN RD STE 170
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5519
Practice Address - Country:US
Practice Address - Phone:435-640-3420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health