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NPI Code Detail

MEDICARE: EMILY C FEELEY LCSW, LLC

MEDICARE: EMILY C FEELEY LCSW, LLC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1518476134
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMILY C FEELEY LCSW, LLC
Provider Business Mailing Address
First Line : 1630 OLDTOWN RD
Second Line :
City : EDGEWATER
State : MD
Zip : 21037-2412
Country : US
Telephone Number : 410-212-7191
Fax Number :
Provider Business Practice Location Address
First Line : 518 S CAMP MEADE RD STE 4
Second Line :
City : LINTHICUM HEIGHTS
State : MD
Zip : 21090-2766
Country : US
Telephone Number : 410-212-7191
Fax Number :
Authorized Official
Title or Position : THERAPIST
Name : MRS. EMILY C FEELEY
Credential : LCSW-C
Telephone Number : 410-212-7191
Provider Enumeration Date : 09/26/2017
Last Update Date : 09/26/2017

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