Provider Demographics
NPI:1073665956
Name:FELBERBAUM, SHEILA BIALEK (LCSW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:BIALEK
Last Name:FELBERBAUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 HAMLET DR
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3340
Mailing Address - Country:US
Mailing Address - Phone:631-273-8824
Mailing Address - Fax:631-273-8271
Practice Address - Street 1:70 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3607
Practice Address - Country:US
Practice Address - Phone:631-273-8824
Practice Address - Fax:631-273-8271
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO36602 11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2910139OtherOXFORD
NY179151OtherMHN
NY7488629OtherGHI
NY179151OtherMHN