Provider Demographics
NPI:1548230519
Name:KELLOGG, LINDA M (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:KELLOGG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 452
Mailing Address - Street 2:
Mailing Address - City:LOVINGSTON
Mailing Address - State:VA
Mailing Address - Zip Code:22949-0452
Mailing Address - Country:US
Mailing Address - Phone:434-263-6080
Mailing Address - Fax:434-263-6081
Practice Address - Street 1:622 FRONT ST
Practice Address - Street 2:
Practice Address - City:LOVINGSTON
Practice Address - State:VA
Practice Address - Zip Code:22949-0452
Practice Address - Country:US
Practice Address - Phone:434-263-6080
Practice Address - Fax:434-263-6081
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAO89709MOtherSENTARA HEALTH MANAGEMENT
VA020115OtherANTHEM BC & BS
VA020115OtherANTHEM HEALTHKEEPERS
VA487480OtherVALUE OPTIONS
VAO89709MOtherSOUTHERN HEALTH
VA2177055OtherCIGNA BEHAVIORAL HEALTH
VAO89709MMedicaid
VA020115Medicaid
VA254011OtherCOMPSYCH