Provider Demographics
NPI:1760786909
Name:STANTON, FELECIA RENEE (LPC-A)
Entity Type:Individual
Prefix:
First Name:FELECIA
Middle Name:RENEE
Last Name:STANTON
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SPARROW RD
Mailing Address - Street 2:
Mailing Address - City:BENNETTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29512-5484
Mailing Address - Country:US
Mailing Address - Phone:843-544-8464
Mailing Address - Fax:
Practice Address - Street 1:510 SPARROW RD
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-5484
Practice Address - Country:US
Practice Address - Phone:843-544-8464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health