Provider Demographics
NPI:1881387280
Name:FOOTE, JAY ALAN (MSW, LMSW)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:ALAN
Last Name:FOOTE
Suffix:
Gender:M
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 E 5TH ST UNIT 202
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1981
Mailing Address - Country:US
Mailing Address - Phone:515-423-0284
Mailing Address - Fax:
Practice Address - Street 1:309 E 5TH ST UNIT 202
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1981
Practice Address - Country:US
Practice Address - Phone:515-423-0284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1184791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical