Provider Demographics
NPI:1265655179
Name:FELDMAN, BARRY N (PH D)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:N
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 SUOMI ST
Mailing Address - Street 2:
Mailing Address - City:PAXTON
Mailing Address - State:MA
Mailing Address - Zip Code:01612-1210
Mailing Address - Country:US
Mailing Address - Phone:508-757-5456
Mailing Address - Fax:
Practice Address - Street 1:338 HIGHLAND ST
Practice Address - Street 2:DIRECT DECISION INSTITUTE
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-2143
Practice Address - Country:US
Practice Address - Phone:508-798-2399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1106561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical