Provider Demographics
NPI:1679822688
Name:FEINGOLD, SHAINA GAIL
Entity Type:Individual
Prefix:
First Name:SHAINA
Middle Name:GAIL
Last Name:FEINGOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2837 MONTEREY PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-3959
Mailing Address - Country:US
Mailing Address - Phone:612-508-4250
Mailing Address - Fax:
Practice Address - Street 1:9800 SHELARD PKWY
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-6411
Practice Address - Country:US
Practice Address - Phone:763-577-2489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN252821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical