Provider Demographics
NPI:1083791982
Name:FEINBLUM, SANDRA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:FEINBLUM
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 1:158-18 RIVERSIDE DRIVE WEST
Mailing Address - Street 2:APT. 1N50
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1022
Mailing Address - Country:US
Mailing Address - Phone:212-568-2149
Mailing Address - Fax:
Practice Address - Street 1:31 WASHINGTON SQUARE WEST
Practice Address - Street 2:SUITE, 6E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-674-0885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR021032-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical