Healthcare Provider Details

I. General information

NPI: 1558187013
Provider Name (Legal Business Name): ANNA FERKO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024
Certification Date: 12/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3651 E BASELINE RD
GILBERT AZ
85234-2689
US

IV. Provider business mailing address

12806 S PAI ST
PHOENIX AZ
85044-4109
US

V. Phone/Fax

Practice location:
  • Phone: 614-537-9882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: