Provider Demographics
NPI:1386123073
Name:FOAT, CHIQUITA RENEE (ICADC)
Entity type:Individual
Prefix:
First Name:CHIQUITA
Middle Name:RENEE
Last Name:FOAT
Suffix:
Gender:F
Credentials:ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SOMERDALE RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1901
Mailing Address - Country:US
Mailing Address - Phone:856-428-5688
Mailing Address - Fax:856-428-0949
Practice Address - Street 1:108 SOMERDALE RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1901
Practice Address - Country:US
Practice Address - Phone:856-428-5688
Practice Address - Fax:856-428-0949
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37CA00088700101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)