Provider Demographics
NPI:1962452946
Name:FEGAN, LINDA D (LMHC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:FEGAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 BLACKMON CT
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4783
Mailing Address - Country:US
Mailing Address - Phone:407-869-0132
Mailing Address - Fax:
Practice Address - Street 1:2909 W STATE ROAD 434
Practice Address - Street 2:SUITE 111
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-4459
Practice Address - Country:US
Practice Address - Phone:407-869-0132
Practice Address - Fax:407-774-9329
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health