Provider Demographics
NPI:1265718324
Name:FEER, MICHAEL H (LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:H
Last Name:FEER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 OTAY LAKES RD
Mailing Address - Street 2:SPACE #164
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-3103
Mailing Address - Country:US
Mailing Address - Phone:619-630-1071
Mailing Address - Fax:
Practice Address - Street 1:765 3RD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5841
Practice Address - Country:US
Practice Address - Phone:619-476-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical