Provider Demographics
NPI:1780673491
Name:KORMAN, FELICIA (LCSW)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:KORMAN
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 1:4101 W GREEN OAKS BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-6800
Mailing Address - Country:US
Mailing Address - Phone:817-563-4949
Mailing Address - Fax:817-556-4941
Practice Address - Street 1:5530 OAK BRANCH DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4538
Practice Address - Country:US
Practice Address - Phone:817-563-4949
Practice Address - Fax:817-563-4941
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX039611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A6623Medicare ID - Type Unspecified