Individual provider Active NPI

Linda Fettmann, LCSW

  • Clinical Social Worker
  • Valhalla, NY
National Provider Identifier
1306151923
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R05213 Issued in NY
Practice address
20 Hospital Oval W
Valhalla, NY 10595-1559
Phone
(914) 493-1086
Fax
(914) 493-1023
NPI assigned
Aug 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R05213 NY Primary

Addresses

Primary practice location

20 Hospital Oval W
Valhalla, NY 10595-1559

Mailing address

20 Hospital Oval W
Valhalla, NY 10595-1559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R05213NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wihd Inc PastSince Jul 1, 2005 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1306151923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HOSPITAL OVAL W",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOSPITAL OVAL W",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951559",
            "telephone_number": "914-493-1086",
            "fax_number": "914-493-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTMANN",
        "first_name": "LINDA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R05213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.