Healthcare Provider Details

I. General information

NPI: 1104703438
Provider Name (Legal Business Name): NATALIE L FEENEY COUNSELOR TRAINEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 N MAIN ST STE 111
BISHOP CA
93514-3013
US

IV. Provider business mailing address

1360 N MAIN ST STE 111
BISHOP CA
93514-3013
US

V. Phone/Fax

Practice location:
  • Phone: 760-871-5053
  • Fax:
Mailing address:
  • Phone: 760-871-5053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC21659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: