Provider Demographics
NPI:1396805982
Name:ORTIZ, FELICITA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:FELICITA
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 DEL PRADO BLVD S STE 410
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-5709
Mailing Address - Country:US
Mailing Address - Phone:239-810-8273
Mailing Address - Fax:239-242-6389
Practice Address - Street 1:2503 DEL PRADO BLVD S STE 410
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-5709
Practice Address - Country:US
Practice Address - Phone:239-810-8273
Practice Address - Fax:239-242-6389
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL75291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW7529OtherLCSW