Provider Demographics
NPI:1689966079
Name:FEELEY, ELIZABETH BOWDOIN (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:BOWDOIN
Last Name:FEELEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:BOWDOIN
Other - Last Name:SCHWARZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:37 OLD SOUTH RD APT 6
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-7003
Mailing Address - Country:US
Mailing Address - Phone:908-403-5594
Mailing Address - Fax:
Practice Address - Street 1:20 VESPER LN
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-4394
Practice Address - Country:US
Practice Address - Phone:508-228-2689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1132091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical