Provider Demographics
NPI:1508153354
Name:FEYDER, LINDA B (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:B
Last Name:FEYDER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:FEYDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:21 N STATION PLZ
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5013
Mailing Address - Country:US
Mailing Address - Phone:516-466-2509
Mailing Address - Fax:516-482-3146
Practice Address - Street 1:21 N STATION PLZ
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5013
Practice Address - Country:US
Practice Address - Phone:516-466-2509
Practice Address - Fax:516-482-3146
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076186-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker