# R FELLDIN LCSW-R CLINICAL SUPPORT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518677178
- **Authorized official:** ROBIN FELLDIN LCSW-R (OWNER)
- **Authorized official phone:** (607) 639-1215

## Contact information

- **Practice address:** 205 ALGERINE ST, AFTON, NY 13730-2203
- **Practice address phone:** (607) 639-1215
- **Mailing address:** 205 ALGERINE ST, AFTON, NY 13730-2203
- **Mailing address phone:** (607) 639-1215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/05/2022
- **Last updated:** 12/05/2022