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Organization

FOOTPRINTS CARES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIKIA A NOBLE LMHP-R (CEO, DIRECTOR)
(434) 480-2020
Entity
Organization

Contact information

Practice address
409 E MAIN ST STE 102, RICHMOND, VA 23219-3845
(804) 716-8739
(804) 597-3665
Mailing address
409 E MAIN ST STE 102, RICHMOND, VA 23219-3845
(804) 716-8739
(804) 597-3665

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
102L00000X
Psychoanalyst
103K00000X
Behavior Analyst
103T00000X
Psychologist
103TA0400X
Addiction (Substance Use Disorder) Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
103TC0700X
Clinical Psychologist
103TC1900X
Counseling Psychologist
103TC2200X
Clinical Child & Adolescent Psychologist
103TP2701X
Group Psychotherapy Psychologist
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1942825286
VA
Enumeration date
11/22/2021
Last updated
11/22/2021
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