Healthcare Provider Details

I. General information

NPI: 1003553900
Provider Name (Legal Business Name): FELICITY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 05/13/2022
Certification Date: 05/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 HUGUENOT RD STE 312
NORTH CHESTERFIELD VA
23235-4311
US

IV. Provider business mailing address

1901 HUGUENOT RD STE 312
NORTH CHESTERFIELD VA
23235-4311
US

V. Phone/Fax

Practice location:
  • Phone: 804-889-2384
  • Fax:
Mailing address:
  • Phone: 804-889-2384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SIERRA SAVEDGE
Title or Position: CEO
Credential: LPC
Phone: 757-617-1125