Provider Demographics
NPI:1245445097
Name:FEIN, MICHELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:FEIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MICHAL
Other - Middle Name:
Other - Last Name:GHELBENDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5700 LAKE WORTH ROAD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463
Mailing Address - Country:US
Mailing Address - Phone:305-799-6131
Mailing Address - Fax:561-642-9623
Practice Address - Street 1:5700 LAKE WORTH ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463
Practice Address - Country:US
Practice Address - Phone:305-799-6131
Practice Address - Fax:561-642-9623
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5389103TC0700X
FLFLPY5389103TC0700X, 103TP2701X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy