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NPI Code Detail

MEDICARE: DEREKA FEILER MSSA, LISW

MEDICARE: DEREKA FEILER MSSA, LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorI.2102599OH

General Provider Information

NPI Number : 1194304758
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREKA FEILER MSSA, LISW
Provider Business Mailing Address
First Line : 803 E WASHINGTON ST STE 200
Second Line :
City : MEDINA
State : OH
Zip : 44256-3326
Country : US
Telephone Number : 330-636-5000
Fax Number :
Provider Business Practice Location Address
First Line : 803 E WASHINGTON ST STE 200
Second Line :
City : MEDINA
State : OH
Zip : 44256-3326
Country : US
Telephone Number : 330-636-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2021
Last Update Date : 05/28/2024

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