Provider Demographics
NPI:1619186798
Name:REYES, FELI R (LCSW, CASAC)
Entity Type:Individual
Prefix:MISS
First Name:FELI
Middle Name:R
Last Name:REYES
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 1ST AVE
Mailing Address - Street 2:9-H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2611
Mailing Address - Country:US
Mailing Address - Phone:718-574-1400
Mailing Address - Fax:718-919-1535
Practice Address - Street 1:1149-55 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-574-1400
Practice Address - Fax:718-919-1535
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0745581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY074558OtherLCSW
NY7625OtherCASAC