Provider Demographics
NPI:1972789550
Name:RICHARDSON, FELICIA MASON (LCSW, MSW)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:MASON
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:NC
Mailing Address - Zip Code:27844-0074
Mailing Address - Country:US
Mailing Address - Phone:252-578-6542
Mailing Address - Fax:
Practice Address - Street 1:1609 E. 10TH STREET
Practice Address - Street 2:B.E.A.R.S.
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870
Practice Address - Country:US
Practice Address - Phone:252-537-6799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW193461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical