Active NPI
Rebecca Elizabeth Felico, LCSW
- Clinical Social Worker
- Jacksonville, FL
National Provider Identifier
1114544319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW16826
- Practice address
- 11555 Central Pkwy Ste 701
Jacksonville, FL 32224-2699 - Phone
- (904) 209-9534
- NPI assigned
- Jul 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW16826 | FL | Primary |
Addresses
Primary practice location
11555 Central Pkwy Ste 701
Jacksonville, FL 32224-2699
Mailing address
216 12TH St Apt B
St Augustine Beach, FL 32080-6379
Phone (804) 683-7060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902239270 | Other | FL | TRACY RILEY COUNSELING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW16826 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593734400000",
"number": "1114544319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 12TH ST APT B",
"city": "ST AUGUSTINE BEACH",
"state": "FL",
"postal_code": "320806379",
"telephone_number": "804-683-7060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11555 CENTRAL PKWY STE 701",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322242699",
"telephone_number": "904-209-9534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FELICO",
"first_name": "REBECCA",
"middle_name": "ELIZABETH",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-03",
"last_updated": "2020-07-03",
"certification_date": "2020-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW16826",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRACY RILEY COUNSELING",
"identifier": "1902239270",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.