Provider Demographics
NPI:1689313199
Name:FIELDS, FELICIA R (BEHAVIOR HEALTH SPEC)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:R
Last Name:FIELDS
Suffix:
Gender:F
Credentials:BEHAVIOR HEALTH SPEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S CROWLEY RD UNIT 1738
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-3251
Mailing Address - Country:US
Mailing Address - Phone:817-808-1318
Mailing Address - Fax:
Practice Address - Street 1:200 S CROWLEY RD UNIT 1738
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-3251
Practice Address - Country:US
Practice Address - Phone:817-808-1318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1528648854OtherBEHAVIOR HEALTH SPECIALIST