Provider Demographics
NPI:1215607064
Name:PADILLA, FELICIA (MA)
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:
Last Name:PADILLA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:
Other - Last Name:PADILLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:THE MENTOR NETWORK
Mailing Address - Street 1:42 UNION ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-3756
Mailing Address - Country:US
Mailing Address - Phone:978-689-5019
Mailing Address - Fax:
Practice Address - Street 1:280 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1779
Practice Address - Country:US
Practice Address - Phone:978-689-5019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health