MEDICARE: MISS MARIEL TERESA FELD 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	093291	NY

General Provider Information

NPI Number	:	1518513308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARIEL TERESA FELD LCSW

Provider Business Mailing Address
First Line	:	13 HARBOR HILLS DR
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-1808
Country	:	US
Telephone Number	:	516-698-7999
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 HARBOR HILLS DR APT 2101
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-1808
Country	:	US
Telephone Number	:	516-698-7999
Fax Number	:

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

Provider Enumeration Date	:	08/16/2019
Last Update Date	:	12/18/2024

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