Provider Demographics
NPI:1366252017
Name:LOONSFOOT, LIANA RENEE (LCSW)
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:RENEE
Last Name:LOONSFOOT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RAILROAD LN
Mailing Address - Street 2:
Mailing Address - City:DEERTON
Mailing Address - State:MI
Mailing Address - Zip Code:49822-9601
Mailing Address - Country:US
Mailing Address - Phone:906-458-0981
Mailing Address - Fax:
Practice Address - Street 1:14614 N KIERLAND BLVD STE 120
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2743
Practice Address - Country:US
Practice Address - Phone:480-696-1898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011135831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical