Provider Demographics
NPI:1174194823
Name:FELDER, LEON KOJASSAR (LMSW)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:KOJASSAR
Last Name:FELDER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 STATE ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12210-1242
Mailing Address - Country:US
Mailing Address - Phone:908-246-8055
Mailing Address - Fax:
Practice Address - Street 1:355 STATE ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12210-1242
Practice Address - Country:US
Practice Address - Phone:908-246-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057278-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY057278-01OtherNYS OFFICE OF THE PROFESSIONS