Individual provider Active NPI

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  • Social Worker
  • Soldotna, AK
National Provider Identifier
1538020375
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
204671 Issued in AK
Practice address
39233 Forbidden CT
Soldotna, AK 99669-8647
Phone
(775) 815-3682
NPI assigned
Nov 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 204671 AK Primary

Addresses

Primary practice location

39233 Forbidden CT
Soldotna, AK 99669-8647

Mailing address

39233 Forbidden CT
Soldotna, AK 99669-8647
Phone (775) 815-3682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
204671AKMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1538020375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39233 FORBIDDEN CT",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698647",
            "telephone_number": "775-815-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39233 FORBIDDEN CT",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698647",
            "telephone_number": "775-815-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOTE",
        "first_name": "DESIREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-20",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AK",
            "license": "204671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.