Provider Demographics
NPI:1669812749
Name:FELDER, ANTHONY TYRONE (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:TYRONE
Last Name:FELDER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7215 CAMERON RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-2911
Mailing Address - Country:US
Mailing Address - Phone:512-458-2437
Mailing Address - Fax:512-452-3299
Practice Address - Street 1:7215 CAMERON RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752
Practice Address - Country:US
Practice Address - Phone:512-458-2437
Practice Address - Fax:512-452-3299
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX615361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical