Provider Demographics
NPI:1558257378
Name:BLANCE, FELICITY (LMSW)
Entity type:Individual
Prefix:
First Name:FELICITY
Middle Name:
Last Name:BLANCE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 E 102ND ST APT 5F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5742
Mailing Address - Country:US
Mailing Address - Phone:203-803-9826
Mailing Address - Fax:
Practice Address - Street 1:1420 FERRIS PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3611
Practice Address - Country:US
Practice Address - Phone:718-730-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127505104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker