Provider Demographics
NPI:1568740603
Name:FEATHERSTONE, NAMOW KCALBA
Entity Type:Individual
Prefix:MS
First Name:NAMOW
Middle Name:KCALBA
Last Name:FEATHERSTONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 INTERLAKE PASS
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-8056
Mailing Address - Country:US
Mailing Address - Phone:856-397-3323
Mailing Address - Fax:
Practice Address - Street 1:351 INTERLAKE PASS
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-8056
Practice Address - Country:US
Practice Address - Phone:856-397-3323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor