Provider Demographics
NPI:1083199707
Name:MATHIAS, FELICIA D (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:D
Last Name:MATHIAS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-1630
Mailing Address - Country:US
Mailing Address - Phone:781-444-9819
Mailing Address - Fax:
Practice Address - Street 1:354 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-1630
Practice Address - Country:US
Practice Address - Phone:781-444-9819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3371911041S0200X
MA1027312-SW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool