Basic Information
| Provider Information | |||||||||
| NPI: | 1255702965 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FEINBERG | ||||||||
| FirstName: | JOSHUA | ||||||||
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| Credential: | LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9137 | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265069137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042935323 | ||||||||
| FaxNumber: | 3042932325 | ||||||||
| Practice Location | |||||||||
| Address1: | 813 RICHWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265055743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153278506 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2015 | ||||||||
| LastUpdateDate: | 11/19/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | DP00944121 | WV | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.