Provider Demographics
NPI:1316917313
Name:NEUBAUER, FELICIA R (LCSW)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:R
Last Name:NEUBAUER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:R
Other - Last Name:NIERENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 TUCKERTON RD STE 207
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8817
Mailing Address - Country:US
Mailing Address - Phone:856-596-4062
Mailing Address - Fax:
Practice Address - Street 1:205 TUCKERTON RD STE 207
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8817
Practice Address - Country:US
Practice Address - Phone:856-596-4062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045361001041C0700X
NJSC045361001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical