Healthcare Provider Details

I. General information

NPI: 1902652498
Provider Name (Legal Business Name): FELICIA GREEN CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2024
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4905 DICKENS RD STE 202
RICHMOND VA
23230-1953
US

IV. Provider business mailing address

4905 DICKENS RD STE 202
RICHMOND VA
23230-1953
US

V. Phone/Fax

Practice location:
  • Phone: 804-480-3062
  • Fax:
Mailing address:
  • Phone: 804-480-3062
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. FELICIA MICHELLE GREEN
Title or Position: OWNER
Credential: PH.D., L.P.C.
Phone: 804-480-3062