Healthcare Provider Details

I. General information

NPI: 1538043286
Provider Name (Legal Business Name): FELICIA HARMON LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FELICIA STOLIECKAS LLMSW

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 N STATE ST
STANTON MI
48888-9702
US

IV. Provider business mailing address

611 N STATE ST
STANTON MI
48888-9702
US

V. Phone/Fax

Practice location:
  • Phone: 989-831-7520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851120454
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: