Provider Demographics
NPI:1407460678
Name:FOOTE, KRIS REAPE (LCSW)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:REAPE
Last Name:FOOTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRIS
Other - Middle Name:TAMMY
Other - Last Name:REAPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4217 BOSTONIAN DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306-7056
Mailing Address - Country:US
Mailing Address - Phone:518-356-0653
Mailing Address - Fax:
Practice Address - Street 1:4217 BOSTONIAN DR
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12306-7056
Practice Address - Country:US
Practice Address - Phone:518-356-0653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069642-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical