Provider Demographics
NPI:1659478469
Name:FEUER, PETER A (LICSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:A
Last Name:FEUER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 WALNUT STREET (LOWER LEVEL)
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104
Mailing Address - Country:US
Mailing Address - Phone:603-645-7400
Mailing Address - Fax:603-645-7401
Practice Address - Street 1:1667 ELM ST
Practice Address - Street 2:SUITE #11
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1233
Practice Address - Country:US
Practice Address - Phone:603-645-7400
Practice Address - Fax:603-645-7401
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7671041C0700X, 104100000X
MA113652104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH020258994-34OtherHARVARD PILGRIM
NH1408701Y0NH01OtherBLUE CROSS
NH30425099Medicaid
NH1061862OtherCIGNA
NH1408701Y0NH01OtherBLUE CROSS
NHFERE6600Medicare UPIN