Provider Demographics
NPI:1043445083
Name:FEUERMAN, SIMON Y (PSYD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:Y
Last Name:FEUERMAN
Suffix:
Gender:M
Credentials:PSYD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200B MAIN AVENUE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055
Mailing Address - Country:US
Mailing Address - Phone:973-249-8111
Mailing Address - Fax:
Practice Address - Street 1:200 MAIN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5408
Practice Address - Country:US
Practice Address - Phone:973-249-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SWCO52629001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical