Healthcare Provider Details

I. General information

NPI: 1740427541
Provider Name (Legal Business Name): DEANNA LYNN FEHER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 N 12TH AVE BLDG B
ARCADIA FL
34266-8752
US

IV. Provider business mailing address

206 PARK PLACE BLVD
KISSIMMEE FL
34741-2344
US

V. Phone/Fax

Practice location:
  • Phone: 863-494-1242
  • Fax: 863-491-0466
Mailing address:
  • Phone: 407-846-0023
  • Fax: 407-483-1064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW9104
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: