Provider Demographics
NPI:1245489707
Name:FELDMAIER, AMY (LISW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:FELDMAIER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 STATE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-2605
Mailing Address - Country:US
Mailing Address - Phone:855-227-6562
Mailing Address - Fax:
Practice Address - Street 1:6000 LOMBARDO CTR LOWR 2
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-6905
Practice Address - Country:US
Practice Address - Phone:855-227-6562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0800731104100000X
OHI.12010801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker