Healthcare Provider Details

I. General information

NPI: 1811262116
Provider Name (Legal Business Name): MATTHEW FERREIRA MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 01/03/2021
Certification Date: 01/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 HOWE ST STE 4
NEW HAVEN CT
06511-4620
US

IV. Provider business mailing address

48 HOWE ST STE 4
NEW HAVEN CT
06511-4620
US

V. Phone/Fax

Practice location:
  • Phone: 833-999-7662
  • Fax:
Mailing address:
  • Phone: 833-999-7662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number82070400001
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: