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General NPI Number Information
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NPI Number | 1780644203
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Entity Type | Individual
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Provider Name | JANICE FELIXSON LCSW LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2200 NO PONCE DE LEON BLVD SUITE #3
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City | ST AUGUSTINE
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State | FL
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Zip | 32084
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Country | US
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Telephone | 904-824-1152
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4412
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City | ST AUGUSTINE
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State | FL
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Zip | 32085-4412
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Country | US
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Telephone | 904-824-1152
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Fax |
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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 | SW0002848
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT0000584
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License Number State | FL
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