Provider Demographics
NPI:1639940885
Name:FELDMAN, MARCY ELLEN (LMSW)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:ELLEN
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6846 CRESTWAY DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-2809
Mailing Address - Country:US
Mailing Address - Phone:248-895-1450
Mailing Address - Fax:
Practice Address - Street 1:6846 CRESTWAY DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-2809
Practice Address - Country:US
Practice Address - Phone:248-895-1450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011175691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical