Provider Demographics
NPI:1053764746
Name:FELDMANN, ERIN (LISW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:FELDMANN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:GLENN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11333 AURORA AVE
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-7908
Mailing Address - Country:US
Mailing Address - Phone:515-557-3100
Mailing Address - Fax:515-557-3126
Practice Address - Street 1:11333 AURORA AVE
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7908
Practice Address - Country:US
Practice Address - Phone:515-557-3100
Practice Address - Fax:515-557-3126
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA042091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1194753863Medicaid
0671503Medicare UPIN
0671503Medicare PIN