Provider Demographics
NPI:1336360163
Name:FELDBERG, CARA ANN (PHD)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:ANN
Last Name:FELDBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 HYDE ST.
Mailing Address - Street 2:
Mailing Address - City:NEWTON HIGHLANDS
Mailing Address - State:MA
Mailing Address - Zip Code:02461
Mailing Address - Country:US
Mailing Address - Phone:617-965-1701
Mailing Address - Fax:
Practice Address - Street 1:1105 MASSACHUSSETS AVENUE
Practice Address - Street 2:SUITE #3B
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-576-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPY6865-PR103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical