Healthcare Provider Details

I. General information

NPI: 1588575146
Provider Name (Legal Business Name): FELICIA M KING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 W VLIET ST, MILWAUKEE, WI 53208
MILWAUKEE WI
53209
US

IV. Provider business mailing address

5225 W VLIET ST, MILWAUKEE, WI 53208
MILWAUKEE WI
53209
US

V. Phone/Fax

Practice location:
  • Phone: 414-475-8393
  • Fax:
Mailing address:
  • Phone: 414-475-8393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number3001029009
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: