Provider Demographics
NPI:1568522175
Name:FELTUS, BRADFORD L (LMHC, LADC-I, CADAC)
Entity Type:Individual
Prefix:
First Name:BRADFORD
Middle Name:L
Last Name:FELTUS
Suffix:
Gender:M
Credentials:LMHC, LADC-I, CADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 GRANT WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01523-3123
Mailing Address - Country:US
Mailing Address - Phone:978-227-5105
Mailing Address - Fax:
Practice Address - Street 1:70 HIGH ST
Practice Address - Street 2:SUITE 209
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-2922
Practice Address - Country:US
Practice Address - Phone:978-365-4966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA160101YA0400X
MA4781101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional