NPIMap

Organization Active NPI

Feathergill & Associates LLC

  • Clinical Psychologist
  • Mishawaka, IN
National Provider Identifier
1821369836
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20041616A Issued in IN
Legal business name
FEATHERGILL & ASSOCIATES LLC
Practice address
3625 Park PL W
Suite 150
Mishawaka, IN 46545-3561
Phone
(574) 282-1090
Fax
(866) 540-3094
NPI assigned
Jan 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Authorized official

Name
Dr. Jeffrey Feathergill, PSY.D.NPI 1982632329
Title
Director
Phone
(574) 282-1090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X 20041616A IN
Adult Development & Aging PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0700X 20041616A IN
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 20041616A IN Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 2041616A IN

Addresses

Primary practice location

3625 Park PL W
Suite 150
Mishawaka, IN 46545-3561

Mailing address

3625 Park PL W
Suite 150
Mishawaka, IN 46545-3561
Phone (574) 282-1090

National Provider Directory

National Provider Directory

Locations

3625 Park Pl W
Ste 150
Mishawaka, IN 46545
Phone (574) 282-1090

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1821369836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 PARK PL W",
            "address_2": "SUITE 150",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453561",
            "telephone_number": "574-282-1090",
            "fax_number": "866-504-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 PARK PL W",
            "address_2": "SUITE 150",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453561",
            "telephone_number": "574-282-1090",
            "fax_number": "866-540-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEATHERGILL & ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "FEATHERGILL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "574-282-1090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "20041616A",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "IN",
            "license": "20041616A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041616A",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "2041616A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.