Provider Demographics
NPI:1821369836
Name:FEATHERGILL & ASSOCIATES LLC
Entity Type:Organization
Organization Name:FEATHERGILL & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:FEATHERGILL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:574-282-1090
Mailing Address - Street 1:3625 PARK PL W
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3561
Mailing Address - Country:US
Mailing Address - Phone:574-282-1090
Mailing Address - Fax:866-504-3094
Practice Address - Street 1:3625 PARK PL W
Practice Address - Street 2:SUITE 150
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3561
Practice Address - Country:US
Practice Address - Phone:574-282-1090
Practice Address - Fax:866-540-3094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-23
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IN20041616A103TA0400X, 103TA0700X, 103TC0700X
IN2041616A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty