Healthcare Provider Details
I. General information
NPI: 1154149656
Provider Name (Legal Business Name): HARMONY FELDMAN MCCULLOUGH LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/02/2024
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
324 W SUPERIOR ST STE 620
DULUTH MN
55802-1723
US
IV. Provider business mailing address
324 W SUPERIOR ST STE 620
DULUTH MN
55802-1723
US
V. Phone/Fax
- Phone: 218-606-1797
- Fax: 651-925-0039
- Phone: 218-606-1797
- Fax: 651-925-0039
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 25473 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: