MEDICARE: IVY J FELDER LPC

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	101YP2500X	Professional Counselor	PC008040	PA
2	101YP2500X	Professional Counselor	LCPC9407	ID
3	101YP2500X	Professional Counselor	PC-0011244	DE

General Provider Information

NPI Number	:	1881343028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVY J FELDER LPC

Provider Business Mailing Address
First Line	:	5125 N SYDENHAM ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-1615
Country	:	US
Telephone Number	:	267-265-1278
Fax Number	:

Provider Business Practice Location Address
First Line	:	94 GLENDALE RD
Second Line	:
City	:	BOYERTOWN
State	:	PA
Zip	:	19512-7696
Country	:	US
Telephone Number	:	267-265-1278
Fax Number	:

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

Provider Enumeration Date	:	03/23/2022
Last Update Date	:	03/04/2026

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