MEDICARE: MS. VICKIE SMITH FELIX MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW8132	FL

General Provider Information

NPI Number	:	1619109055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICKIE SMITH FELIX MSW, LCSW

Provider Business Mailing Address
First Line	:	6051 MAGGIES CIR UNIT 16
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-8504
Country	:	US
Telephone Number	:	904-537-1004
Fax Number	:

Provider Business Practice Location Address
First Line	:	7950 MARTIN LOOP
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31905-5647
Country	:	US
Telephone Number	:	706-544-4833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2009
Last Update Date	:	08/19/2009

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