Individual provider Active NPI

Tanya Footman, LCSW

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1992461479
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11200 Issued in FL
Practice address
825 Benjamin Chaires Rd
Tallahassee, FL 32317-7680
Phone
(850) 933-3644
NPI assigned
Nov 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW11200 FL Primary

Addresses

Primary practice location

825 Benjamin Chaires Rd
Tallahassee, FL 32317-7680

Mailing address

825 Benjamin Chaires Rd
Tallahassee, FL 32317-7680
Phone (850) 933-3644

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
SW11200FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1992461479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 BENJAMIN CHAIRES RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323177680",
            "telephone_number": "850-933-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 BENJAMIN CHAIRES RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323177680",
            "telephone_number": "850-933-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOTMAN",
        "first_name": "TANYA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.