Provider Demographics
NPI:1346265279
Name:KATHLEEN J. FEIL, PHD, LP, PLC
Entity Type:Organization
Organization Name:KATHLEEN J. FEIL, PHD, LP, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:FEIL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:651-308-5581
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:MARINE ON SAINT CROIX
Mailing Address - State:MN
Mailing Address - Zip Code:55047-0163
Mailing Address - Country:US
Mailing Address - Phone:651-308-5581
Mailing Address - Fax:
Practice Address - Street 1:189 EGRET LN
Practice Address - Street 2:
Practice Address - City:MARINE ON SAINT CROIX
Practice Address - State:MN
Practice Address - Zip Code:55047-8641
Practice Address - Country:US
Practice Address - Phone:651-308-5581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4051103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN097L7FEOtherBCBS
MN97480OtherHEALTH PARTNERS