Provider Demographics
NPI:1053697615
Name:PRESCOTT, FELICIA H (LPC)
Entity type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:H
Last Name:PRESCOTT
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 1:1547 BATEMAN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-4238
Mailing Address - Country:US
Mailing Address - Phone:434-847-8035
Mailing Address - Fax:434-485-8877
Practice Address - Street 1:620 COURT ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-1312
Practice Address - Country:US
Practice Address - Phone:434-847-8035
Practice Address - Fax:434-485-8877
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004726101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1871542340Medicaid