Provider Demographics
NPI:1245595255
Name:FEINBERG, ALEX D (LMSW-CC)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:D
Last Name:FEINBERG
Suffix:
Gender:M
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 FOREST AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-2009
Mailing Address - Country:US
Mailing Address - Phone:207-854-1030
Mailing Address - Fax:207-899-4623
Practice Address - Street 1:470 FOREST AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2009
Practice Address - Country:US
Practice Address - Phone:207-854-1030
Practice Address - Fax:207-899-4623
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC135661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical