Provider Demographics
NPI:1720353329
Name:BALSAMO, FELICIA (MS IN ED NCSP)
Entity Type:Individual
Prefix:MISS
First Name:FELICIA
Middle Name:
Last Name:BALSAMO
Suffix:
Gender:F
Credentials:MS IN ED NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 UNCAS AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-2951
Mailing Address - Country:US
Mailing Address - Phone:718-541-7800
Mailing Address - Fax:
Practice Address - Street 1:64 UNCAS AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2951
Practice Address - Country:US
Practice Address - Phone:718-541-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool