Provider Demographics
NPI:1679612501
Name:FEINZIG, DOROTHY PRINSKY (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:PRINSKY
Last Name:FEINZIG
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GLOUCESTER ST
Mailing Address - Street 2:NO.1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-1703
Mailing Address - Country:US
Mailing Address - Phone:617-877-9902
Mailing Address - Fax:
Practice Address - Street 1:9 GLOUCESTER ST
Practice Address - Street 2:NO.1
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-1703
Practice Address - Country:US
Practice Address - Phone:617-877-9902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10254641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO 7747OtherBCBS
MAFE P21493Medicare ID - Type UnspecifiedMEDICARE B