Callum Alexander Fedele, MA, CAT-LP

Primary specialty

Drama TherapistTaxonomy code 101200000X

Practice address

291 Wall St Ste 3
Kingston, NY 12401-3849

Phone

(845) 795-8030

NPI assigned

Nov 8, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Evolutionary Psychotherapy LCSW PLLC

  • Clinical Social Worker
  • Kingston, NY
  • NPI 1679244925
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1144985854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 WALL ST STE 3",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013849",
            "telephone_number": "845-795-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 WALL ST STE 3",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013849",
            "telephone_number": "845-795-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDELE",
        "first_name": "CALLUM",
        "middle_name": "ALEXANDER",
        "credential": "MA, CAT-LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101200000X",
            "taxonomy_group": "",
            "desc": "Drama Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward M Farhangi, MD
• Marie C Farrell, RN
• Marie Een Farrell, LMSW
• Sheri Farrell
• John R.M. Fay, MHC-LP
• James M. Feeney, MD, FACS
• Honey Jane Fein, NP
• Joseph James Felczak, RPH04/08/1934
• Karen Fellows
• Felly's Homecare-Caring for You As a Family LLC

• Drama Therapist in Kingston, NY
• Providers in Kingston, NY by specialty
• Drama Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.