Provider Demographics
NPI:1194304758
Name:FEILER, DEREKA (MSSA, LISW)
Entity type:Individual
Prefix:
First Name:DEREKA
Middle Name:
Last Name:FEILER
Suffix:
Gender:F
Credentials:MSSA, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 E WASHINGTON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-3326
Mailing Address - Country:US
Mailing Address - Phone:330-636-5000
Mailing Address - Fax:
Practice Address - Street 1:803 E WASHINGTON ST STE 200
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3326
Practice Address - Country:US
Practice Address - Phone:330-636-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2102599101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health