Provider Demographics
NPI:1245585355
Name:FOOTE, KELLEE MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KELLEE
Middle Name:MARIE
Last Name:FOOTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:KELLEE
Other - Middle Name:MARIE
Other - Last Name:FOOTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:1012 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5044
Practice Address - Country:US
Practice Address - Phone:573-471-0330
Practice Address - Fax:573-471-0461
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20150002911041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical