Provider Demographics
NPI:1235005190
Name:FEDDECK, ANNEMARIE LIN (LMSW)
Entity type:Individual
Prefix:MISS
First Name:ANNEMARIE
Middle Name:LIN
Last Name:FEDDECK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WHITE PLAINS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5172
Mailing Address - Country:US
Mailing Address - Phone:914-332-1300
Mailing Address - Fax:
Practice Address - Street 1:660 WHITE PLAINS RD STE 100
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5172
Practice Address - Country:US
Practice Address - Phone:914-332-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112028104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker