Healthcare Provider Details

I. General information

NPI: 1306660006
Provider Name (Legal Business Name): FELICA CLAY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 RIVERSIDE DR
MONROE LA
71201-6211
US

IV. Provider business mailing address

622 RIVERSIDE DR
MONROE LA
71201-6211
US

V. Phone/Fax

Practice location:
  • Phone: 318-801-0011
  • Fax: 318-574-0066
Mailing address:
  • Phone: 318-398-0945
  • Fax: 318-398-0099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number19378
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: