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General NPI Number Information
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NPI Number | 1386455467
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Entity Type | Individual
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Provider Name | JENNIFER CELESTE FOOTMAN MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 9475 BRIAR VILLAGE PT STE 320
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7905
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Country | US
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Telephone | 719-985-5264
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Fax |
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Provider Business Mailing Address
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Address Line | 14530 WYANDOTT DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80908-2832
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Country | US
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Telephone | 719-985-5264
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSW.0009926016
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License Number State | CO
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