Provider Demographics
NPI:1760888325
Name:FOOTS, KINYADA FOOTS (LMSW)
Entity Type:Individual
Prefix:
First Name:KINYADA FOOTS
Middle Name:
Last Name:FOOTS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 COMMON ST STE 500
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2467
Mailing Address - Country:US
Mailing Address - Phone:504-302-1323
Mailing Address - Fax:
Practice Address - Street 1:1010 COMMON ST STE 500
Practice Address - Street 2:SUITE 106
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2467
Practice Address - Country:US
Practice Address - Phone:504-302-1323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8529104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA600771346Medicaid