Provider Demographics
NPI:1285694927
Name:IVEY-TOURE, FELICIA URSULA (MA,CASAC, LMHC)
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:URSULA
Last Name:IVEY-TOURE
Suffix:
Gender:F
Credentials:MA,CASAC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15206 123RD AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2311
Mailing Address - Country:US
Mailing Address - Phone:718-362-0615
Mailing Address - Fax:718-738-4587
Practice Address - Street 1:11929 80TH RD
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1105
Practice Address - Country:US
Practice Address - Phone:718-362-0615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-26
Last Update Date:2024-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11694101YA0400X
FLMH22564101YM0800X
FLMCAP.0101032101YA0400X
FLTPMC694101YM0800X
NJ37PC00967500101YP2500X
CT46.006489101YP2500X
NY2635101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07669318Medicaid