Provider Demographics
NPI:1962444091
Name:FELDMAN, MERYL (LCSW PLLC)
Entity Type:Individual
Prefix:
First Name:MERYL
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:LCSW PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 CHESTNUT LN
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3738
Mailing Address - Country:US
Mailing Address - Phone:516-398-7740
Mailing Address - Fax:516-280-5598
Practice Address - Street 1:455 CEDAR LN
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-3709
Practice Address - Country:US
Practice Address - Phone:516-398-7740
Practice Address - Fax:516-280-5598
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070413-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical