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General NPI Number Information
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NPI Number | 1598063398
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Entity Type | Individual
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Provider Name | FELECIA L BRODIE LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 542 BERLIN CROSS KEYS RD #3, SUITE 201
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-4367
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Country | US
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Telephone | 215-620-5516
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Fax | 856-262-1422
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Provider Business Mailing Address
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Address Line | 542 BERLIN CROSSKEYS RD # 3 SUITE 201
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-4367
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Country | US
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Telephone | 215-620-5516
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Fax | 856-262-1422
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SCO5327400
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License Number State | NJ
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