MEDICARE: JOHN FRANCIS FEENEY LCSW

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1023618311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN FRANCIS FEENEY LCSW

Provider Business Mailing Address
First Line	:	1108 E MAIN ST STE 900
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23219-3522
Country	:	US
Telephone Number	:	804-320-1980
Fax Number	:	804-320-1982

Provider Business Practice Location Address
First Line	:	1108 E MAIN ST STE 900
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23219-3522
Country	:	US
Telephone Number	:	804-320-1980
Fax Number	:	804-320-1982

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2020
Last Update Date	:	10/27/2020

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