Provider Demographics
NPI:1245050558
Name:FOOTE, JADA (LMSW)
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:
Last Name:FOOTE
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 1:243 PARKSIDE MEADOW DR SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-2142
Mailing Address - Country:US
Mailing Address - Phone:404-454-0278
Mailing Address - Fax:
Practice Address - Street 1:243 PARKSIDE MEADOW DR SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-2142
Practice Address - Country:US
Practice Address - Phone:404-454-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical