Provider Demographics
NPI:1992849319
Name:FEAZELL, CARANN S (MSSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:CARANN
Middle Name:S
Last Name:FEAZELL
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 KINGS HWY N
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1017
Mailing Address - Country:US
Mailing Address - Phone:856-755-0800
Mailing Address - Fax:856-482-5655
Practice Address - Street 1:496 KINGS HWY N
Practice Address - Street 2:SUITE 206
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1017
Practice Address - Country:US
Practice Address - Phone:856-755-0800
Practice Address - Fax:856-482-5655
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014861001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical