Provider Demographics
NPI:1609409028
Name:MARGOT M FELDVEBEL LCSW
Entity Type:Organization
Organization Name:MARGOT M FELDVEBEL LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:MANDIRA
Authorized Official - Last Name:FELDVEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-328-9448
Mailing Address - Street 1:1125 FOREST RD NW
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:NM
Mailing Address - Zip Code:87114-1915
Mailing Address - Country:US
Mailing Address - Phone:505-328-9448
Mailing Address - Fax:505-340-3764
Practice Address - Street 1:1003 LUNA CIR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1973
Practice Address - Country:US
Practice Address - Phone:505-328-9448
Practice Address - Fax:505-340-3764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMC-09997OtherCLINICAL SOCIAL WORK LICENSE #
13816274OtherCAQH