Provider Demographics
NPI:1417143348
Name:HUMPHERY, FELICIA ANNETTE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:ANNETTE
Last Name:HUMPHERY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:FELICIA
Other - Middle Name:ANNETTE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1941 EAST RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-6010
Mailing Address - Country:US
Mailing Address - Phone:713-486-8550
Mailing Address - Fax:713-692-2500
Practice Address - Street 1:2620 E CROSSTIMBERS ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-8629
Practice Address - Country:US
Practice Address - Phone:713-486-8550
Practice Address - Fax:713-692-2500
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX339701041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX343192601Medicaid