Provider Demographics
NPI:1346575693
Name:FELD, YOSEF Y (MSW,LCSW)
Entity type:Individual
Prefix:
First Name:YOSEF
Middle Name:Y
Last Name:FELD
Suffix:
Gender:M
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06710-1648
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:50 RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06710-1648
Practice Address - Country:US
Practice Address - Phone:203-797-9778
Practice Address - Fax:203-797-9858
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0087051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT539521OtherTRICARE NORTH-MHN WELLMORE,INC
CT539521OtherMHN- WELLMORE,INC.
12770882OtherCAQH
CT5942959OtherAETNA BEHAVIORAL HEALTH-WELLMORE,INC
CT008054990Medicaid