Healthcare Provider Details

I. General information

NPI: 1285025486
Provider Name (Legal Business Name): NICOLE LAFERRIERE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2015
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 E WASHINGTON BLVD
CRESCENT CITY CA
95531-8342
US

IV. Provider business mailing address

PO BOX 1598
COLFAX CA
95713-1598
US

V. Phone/Fax

Practice location:
  • Phone: 707-460-1802
  • Fax:
Mailing address:
  • Phone: 530-401-2245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number107329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: