Provider Demographics
NPI:1154651792
Name:FELICIANO, FERDNAND (MA, LMHC)
Entity Type:Individual
Prefix:MR
First Name:FERDNAND
Middle Name:
Last Name:FELICIANO
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9020 RANCHO DEL RIO DR
Mailing Address - Street 2:STE. #136
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5274
Mailing Address - Country:US
Mailing Address - Phone:727-848-0013
Mailing Address - Fax:
Practice Address - Street 1:9020 RANCHO DEL RIO DR
Practice Address - Street 2:STE. #136
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-5274
Practice Address - Country:US
Practice Address - Phone:727-848-0013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6348101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health