Provider Demographics
NPI:1396527107
Name:FEICKERT, HALEY (LCSW)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:FEICKERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 BOYLSTON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4671
Mailing Address - Country:US
Mailing Address - Phone:315-461-7457
Mailing Address - Fax:
Practice Address - Street 1:68 BOYLSTON ST APT 2
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4671
Practice Address - Country:US
Practice Address - Phone:315-461-7457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2298591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical