Provider Demographics
NPI:1609687060
Name:FELDMAN, LISA RENEE (MSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:RENEE
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 MERCER RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1015
Mailing Address - Country:US
Mailing Address - Phone:609-828-3132
Mailing Address - Fax:
Practice Address - Street 1:515 MERCER RD
Practice Address - Street 2:
Practice Address - City:MERION STATION
Practice Address - State:PA
Practice Address - Zip Code:19066-1015
Practice Address - Country:US
Practice Address - Phone:609-828-3132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0167701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical