Provider Demographics
NPI:1376986372
Name:FEINTUCH, JONATHON MARC (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JONATHON
Middle Name:MARC
Last Name:FEINTUCH
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 1:141 WASHINGTON AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1669
Mailing Address - Country:US
Mailing Address - Phone:516-439-8093
Mailing Address - Fax:
Practice Address - Street 1:141 WASHINGTON AVE
Practice Address - Street 2:STE 200
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1669
Practice Address - Country:US
Practice Address - Phone:516-439-8093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073688101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health