Provider Demographics
NPI:1124292917
Name:FELDMAN, MARILEE (LCPC)
Entity type:Individual
Prefix:MS
First Name:MARILEE
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:MARILEE
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:535 PLAINFIELD RD STE H
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7626
Mailing Address - Country:US
Mailing Address - Phone:630-269-2886
Mailing Address - Fax:
Practice Address - Street 1:545 PLAINFIELD RD
Practice Address - Street 2:SUITE E
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7600
Practice Address - Country:US
Practice Address - Phone:630-269-2886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006809101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional