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Individual

MR. FREDERICK L FEARDAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2804 W SAN RAFAEL ST, TAMPA, FL 33629-6136
(813) 420-6696
Mailing address
2804 W SAN RAFAEL ST, TAMPA, FL 33629-6136
(813) 420-6696

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
SW3162
FL
1041C0700X
Clinical Social Worker
Primary
SW3162
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
763999600
FL
05
766499100
FL
Enumeration date
01/22/2007
Last updated
04/21/2023
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