Provider Demographics
NPI:1619000783
Name:FELTER, LINDA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:FELTER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LINCOLN AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-7003
Mailing Address - Country:US
Mailing Address - Phone:860-585-5082
Mailing Address - Fax:860-585-1561
Practice Address - Street 1:5 LINCOLN AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-7003
Practice Address - Country:US
Practice Address - Phone:860-585-5082
Practice Address - Fax:860-585-1561
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001129106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT410001129CT01OtherANTHEM BC BS
CT366521OtherMHN
CT410001129CT01OtherANTHEM NATIONAL ACCOUNTS
CT9402514OtherPRIVATE HEALTHCARE SYSTEM
CT366521OtherHEALTH MANAGEMENT SYSTEM
CT410001129CT01OtherANTHEM BEHAVIORAL HEALTH
CT410001129CT01OtherANTHEM FEDERAL
CT410001129CT01OtherANTHEM BLUE CARD