Provider Demographics
NPI:1306343785
Name:FELDKAMP, KERI (LCSW)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:FELDKAMP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:
Other - Last Name:KNIGHT FELDKAMP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:119 S SHERRIN AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3237
Mailing Address - Country:US
Mailing Address - Phone:502-777-3070
Mailing Address - Fax:
Practice Address - Street 1:119 S SHERRIN AVE STE 240
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3237
Practice Address - Country:US
Practice Address - Phone:502-777-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical