Provider Demographics
NPI:1023169232
Name:MAXWELL, FELICIA DI MARCO (LISW)
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:DI MARCO
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 N HIGH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2381
Mailing Address - Country:US
Mailing Address - Phone:614-888-1800
Mailing Address - Fax:614-888-9664
Practice Address - Street 1:7100 N HIGH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2381
Practice Address - Country:US
Practice Address - Phone:614-888-1800
Practice Address - Fax:614-888-9664
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00088391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical