Provider Demographics
NPI:1164175550
Name:BILLUPS, FELICIA ELAINE (RN, LSW, CRC, CDMS)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ELAINE
Last Name:BILLUPS
Suffix:
Gender:F
Credentials:RN, LSW, CRC, CDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 WHETSTONE CT
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-2971
Mailing Address - Country:US
Mailing Address - Phone:937-726-8282
Mailing Address - Fax:
Practice Address - Street 1:1522 LA COSTA DR
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-7028
Practice Address - Country:US
Practice Address - Phone:937-726-8282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.389406163W00000X
OHC.2305010101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No163W00000XNursing Service ProvidersRegistered Nurse