Provider Demographics
NPI:1144305103
Name:NILAND, FELICE (LCSW CASAC)
Entity type:Individual
Prefix:MRS
First Name:FELICE
Middle Name:
Last Name:NILAND
Suffix:
Gender:F
Credentials:LCSW CASAC
Other - Prefix:
Other - First Name:FELICE
Other - Middle Name:
Other - Last Name:DIDONNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:86 PENINSULA DRIVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702
Mailing Address - Country:US
Mailing Address - Phone:631-321-4699
Mailing Address - Fax:
Practice Address - Street 1:86 PENINSULA DRIVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702
Practice Address - Country:US
Practice Address - Phone:631-321-4699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03290311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN77161Medicare ID - Type Unspecified