Provider Demographics
NPI:1912325903
Name:FELKER, LISA C (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:C
Last Name:FELKER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:LIA
Other - Middle Name:
Other - Last Name:FELKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:1307 SEVEN LOCKS RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2909
Mailing Address - Country:US
Mailing Address - Phone:240-777-9849
Mailing Address - Fax:
Practice Address - Street 1:1307 SEVEN LOCKS RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854-2909
Practice Address - Country:US
Practice Address - Phone:240-777-9849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical