Provider Demographics
NPI:1821141011
Name:MURAD-FELDMAN, MARIE (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:MURAD-FELDMAN
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1742 W DIVERSEY PKWY # 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1010
Mailing Address - Country:US
Mailing Address - Phone:773-230-0902
Mailing Address - Fax:
Practice Address - Street 1:1742 W DIVERSEY PKWY # 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1010
Practice Address - Country:US
Practice Address - Phone:773-230-0902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-003979101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional