Provider Demographics
NPI:1205353265
Name:PROPHET, FELICIA (LPC)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:PROPHET
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 S 9TH ST # 118
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4111
Mailing Address - Country:US
Mailing Address - Phone:770-628-5368
Mailing Address - Fax:770-502-6686
Practice Address - Street 1:327 S 9TH ST # 118
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4111
Practice Address - Country:US
Practice Address - Phone:770-628-5368
Practice Address - Fax:770-502-6686
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12631101YM0800X
GA010914101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health