Provider Demographics
NPI:1285862821
Name:FELIX, RONDALE K (MS, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:RONDALE
Middle Name:K
Last Name:FELIX
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 CARPENTER RD SE STE 104
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-7905
Mailing Address - Country:US
Mailing Address - Phone:360-888-3776
Mailing Address - Fax:
Practice Address - Street 1:418 CARPENTER RD SE STE 104
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-7905
Practice Address - Country:US
Practice Address - Phone:360-888-3776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC60101821101Y00000X
WA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator