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General NPI Number Information
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NPI Number | 1649661299
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Entity Type | Individual
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Provider Name | JENNIFER FELICITAS LMHCA
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Gender | Female
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 3801 S ZINTEL WAY STE 120
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City | KENNEWICK
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State | WA
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Zip | 99337-5097
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Country | US
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Telephone | 509-438-5126
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Fax | 866-366-5004
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Provider Business Mailing Address
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Address Line | PO BOX 4196
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City | PASCO
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State | WA
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Zip | 99302-4196
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Country | US
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Telephone | 509-438-5126
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Fax | 866-366-5004
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC60480925
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License Number State | WA
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