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General NPI Number Information
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NPI Number | 1750268546
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Entity Type | Individual
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Provider Name | KRISTEN M FELLER LMSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 300 HEBRON AVE STE 203
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City | GLASTONBURY
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State | CT
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Zip | 06033-2192
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Country | US
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Telephone | 860-946-0447
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Fax |
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Provider Business Mailing Address
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Address Line | 33 DOVE LN
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City | MIDDLETOWN
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State | CT
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Zip | 06457-6206
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Country | US
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Telephone | 719-792-9337
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 11531
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License Number State | CT
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