Provider Demographics
NPI:1023035961
Name:FEINSMITH, GLENNIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GLENNIE
Middle Name:
Last Name:FEINSMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:GLENDA
Other - Middle Name:E
Other - Last Name:FEINSMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:998 PLAZA AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3560
Mailing Address - Country:US
Mailing Address - Phone:541-482-0744
Mailing Address - Fax:541-482-0744
Practice Address - Street 1:998 PLAZA AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3560
Practice Address - Country:US
Practice Address - Phone:541-482-0744
Practice Address - Fax:541-482-0744
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR32221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR114161Medicare ID - Type Unspecified