Provider Demographics
NPI:1326504853
Name:FOOTE, CHRISTOPHER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:FOOTE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 S BROAD STREET
Mailing Address - Street 2:STE 1
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-3189
Mailing Address - Country:US
Mailing Address - Phone:800-311-7072
Mailing Address - Fax:704-662-0866
Practice Address - Street 1:207 S BROAD STREET
Practice Address - Street 2:STE 1
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-3189
Practice Address - Country:US
Practice Address - Phone:800-311-7072
Practice Address - Fax:704-662-0866
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0131451041C0700X
NCC0145611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical