Provider Demographics
NPI:1619063047
Name:CORREA, FELICIA ANN (LPC)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ANN
Last Name:CORREA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 WEST 6TH STREET, SUITE 234
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703
Mailing Address - Country:US
Mailing Address - Phone:512-499-8388
Mailing Address - Fax:512-494-0788
Practice Address - Street 1:1717 WEST 6TH STREET, SUITE 234
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703
Practice Address - Country:US
Practice Address - Phone:512-499-8388
Practice Address - Fax:512-494-0788
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0284358Medicaid