Provider Demographics
NPI:1861015984
Name:PITRE, FELICIA M (LICSW, LCSW)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:M
Last Name:PITRE
Suffix:
Gender:F
Credentials:LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 50TH STREET NW
Mailing Address - Street 2:SUITE 100 PMB 7069
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-240-2429
Mailing Address - Fax:
Practice Address - Street 1:4315 50TH STREET NW
Practice Address - Street 2:SUITE 100 PMB 7069
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-240-2429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-22
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1075121041S0200X
DCLC500819791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool