Provider Demographics
NPI:1417014481
Name:FEUTZ, CONNIE (LNHC)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:FEUTZ
Suffix:
Gender:F
Credentials:LNHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 F ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3910
Mailing Address - Country:US
Mailing Address - Phone:360-671-6967
Mailing Address - Fax:
Practice Address - Street 1:1414 F ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3910
Practice Address - Country:US
Practice Address - Phone:360-671-6967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006588101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional