Provider Demographics
NPI:1700223443
Name:MEYER-DELOATCH, FELICEA C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:FELICEA
Middle Name:C
Last Name:MEYER-DELOATCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8749 FLOWERING DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-5603
Mailing Address - Country:US
Mailing Address - Phone:703-909-1072
Mailing Address - Fax:703-690-0674
Practice Address - Street 1:8749 FLOWERING DOGWOOD LN
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-5603
Practice Address - Country:US
Practice Address - Phone:703-909-1072
Practice Address - Fax:703-690-0674
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040080281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical