Provider Demographics
NPI:1770799298
Name:FEIGENBAUM, JUDITH RENEE (LMHC)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:RENEE
Last Name:FEIGENBAUM
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:KEESEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12944-1276
Mailing Address - Country:US
Mailing Address - Phone:518-834-7803
Mailing Address - Fax:
Practice Address - Street 1:61 RIVER ST
Practice Address - Street 2:
Practice Address - City:KEESEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12944-1276
Practice Address - Country:US
Practice Address - Phone:518-834-7803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003010-1170300000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No170300000XOther Service ProvidersGenetic Counselor, MS