Healthcare Provider Details

I. General information

NPI: 1447915129
Provider Name (Legal Business Name): FOOTPRINTS OF CHANGE COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 N 5TH AVE
CANISTOTA SD
57012-2049
US

IV. Provider business mailing address

741 N 5TH AVE
CANISTOTA SD
57012-2049
US

V. Phone/Fax

Practice location:
  • Phone: 605-299-1771
  • Fax: 605-299-1771
Mailing address:
  • Phone: 605-299-1771
  • Fax: 605-299-1771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARIE-ANNE ABENROTH
Title or Position: OWNER
Credential:
Phone: 719-749-6211