Provider Demographics
NPI:1467628347
Name:FELDMAN, MARILYN D (LCSW CCS CADAC LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:D
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:LCSW CCS CADAC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 TURNER RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482
Mailing Address - Country:US
Mailing Address - Phone:781-431-1887
Mailing Address - Fax:781-431-4624
Practice Address - Street 1:11 TURNER RD
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482
Practice Address - Country:US
Practice Address - Phone:781-431-1887
Practice Address - Fax:781-431-4624
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA416106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist