Provider Demographics
NPI:1265525513
Name:FEIFER, DARCI DEANN (MED)
Entity type:Individual
Prefix:MRS
First Name:DARCI
Middle Name:DEANN
Last Name:FEIFER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 IROQUOIS PL
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2791
Mailing Address - Country:US
Mailing Address - Phone:301-682-9220
Mailing Address - Fax:301-698-9746
Practice Address - Street 1:313 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5610
Practice Address - Country:US
Practice Address - Phone:391-682-9220
Practice Address - Fax:301-698-9746
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCO445101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1Y16DDOtherBLUECROSS
MD971800100Medicaid
DCG5480001OtherBLUECROSS