Individual provider Active NPI

Georgena Felicia, LPCC, LMFT

  • Professional Counselor
  • Albuquerque, NM
National Provider Identifier
1417066549
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1697 Issued in NM
Practice address
6837 Glendora Dr NE
Albuquerque, NM 87109
Phone
(505) 856-9661
Fax
(505) 856-9661
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1697 NM Primary

Addresses

Primary practice location

6837 Glendora Dr NE
Albuquerque, NM 87109

Mailing address

6837 Glendora Dr NE
Albuquerque, NM 87109
Phone (505) 350-6202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612001597 NM Order and Referring Only - Mental Health Counselor 6800338385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1697NMMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1417066549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6837 GLENDORA DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87109",
            "telephone_number": "505-350-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6837 GLENDORA DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87109",
            "telephone_number": "505-856-9661",
            "fax_number": "505-856-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICIA",
        "first_name": "GEORGENA",
        "credential": "LPCC, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-11-03",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "1697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.