Provider Demographics
NPI:1427760263
Name:FELDSTEIN, MICHAEL (LADC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:FELDSTEIN
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 HENNEPIN AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3470
Mailing Address - Country:US
Mailing Address - Phone:612-208-2268
Mailing Address - Fax:652-204-5716
Practice Address - Street 1:3255 HENNEPIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-3470
Practice Address - Country:US
Practice Address - Phone:612-353-5639
Practice Address - Fax:952-204-9571
Is Sole Proprietor?:No
Enumeration Date:2022-12-22
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)