Provider Demographics
NPI:1083029896
Name:FELDMAN, ALISA (LMSW)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ALISA
Other - Middle Name:
Other - Last Name:FELDMAN-KATZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:1349 BOXWOOD DR W
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2206
Mailing Address - Country:US
Mailing Address - Phone:516-812-5163
Mailing Address - Fax:
Practice Address - Street 1:1349 BOXWOOD DR W
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2206
Practice Address - Country:US
Practice Address - Phone:516-812-5163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060495-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker