Provider Demographics
NPI:1881343028
Name:FELDER, IVY J (LPC)
Entity type:Individual
Prefix:
First Name:IVY
Middle Name:J
Last Name:FELDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 N SYDENHAM ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-1615
Mailing Address - Country:US
Mailing Address - Phone:267-265-1278
Mailing Address - Fax:
Practice Address - Street 1:94 GLENDALE RD
Practice Address - Street 2:
Practice Address - City:BOYERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19512-7696
Practice Address - Country:US
Practice Address - Phone:267-265-1278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC9407101YM0800X
DEPC-0011244101YM0800X
PAPC008040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health