Provider Demographics
NPI:1225027915
Name:FELTS, LINDA WARD (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:WARD
Last Name:FELTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-5732
Mailing Address - Country:US
Mailing Address - Phone:540-961-8352
Mailing Address - Fax:540-552-3428
Practice Address - Street 1:200 PROFESSIONAL PARK DR SE
Practice Address - Street 2:SUITE 1
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6679
Practice Address - Country:US
Practice Address - Phone:540-552-1402
Practice Address - Fax:540-552-3428
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040015111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8909016Medicaid