Provider Demographics
NPI:1518476134
Name:EMILY C FEELEY LCSW, LLC
Entity Type:Organization
Organization Name:EMILY C FEELEY LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:C
Authorized Official - Last Name:FEELEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-212-7191
Mailing Address - Street 1:1630 OLDTOWN RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2412
Mailing Address - Country:US
Mailing Address - Phone:410-212-7191
Mailing Address - Fax:
Practice Address - Street 1:518 S CAMP MEADE RD STE 4
Practice Address - Street 2:
Practice Address - City:LINTHICUM HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21090-2766
Practice Address - Country:US
Practice Address - Phone:410-212-7191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)